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HOMETOWN DRUG 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
HOMETOWN DRUG INC
Pharmacy Address
2508 GRAY STREET
HOPEWELL, VA 23860-2386
Pharmacy Comments
Contract Details
Approval Date
10/5/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/27/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Roderick Manifold, Executive Director
(434) 581-3271 Ext: 10700
Contract Pharmacy Representative
George Fetko, Owner
(804) 458-3784
Signed By Date
10/5/2016
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