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FARMVILLE PHARMACY,INC
CH030700 CENTRAL VIRGINIA HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
CENTRAL VIRGINIA HEALTH SERVICES, INC.
Subdivision Name
CVHS Buckingham
Type
HRSA-Funded Health Center
340B ID
CH030700
Entity Address
25892 N James Madison Hwy
New Canton, VA 23123-2234
Grant Number
H80CS00479
Participating Start Date
7/1/1995
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
FARMVILLE PHARMACY,INC
Pharmacy Address
308A SOUTH MAIN ST
FARMVILLE, VA 23901
Pharmacy Comments
Contract Details
Approval Date
4/6/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/20/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Roderick Manifold, Executive Director
(434) 581-3271 Ext: 10700
Contract Pharmacy Representative
Scott Kim, PIC
(434) 392-1985
Signed By Date
4/6/2016
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