340B Drug Pricing Program Database

Pharmacy Name

RIVERSIDE HOSPITAL, INC.

Pharmacy Address

D/B/A PAVILION PHARMACY
500 J. CLYDE MORRIS BOULEVARD
ROOM 1-501
NEWPORT NEWS, VA 23601-1929

Pharmacy Comments

Approval Date

11/13/2013

Contract Begin Date

1/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/31/2022
Ownership change

Covered Entity Signing Official

WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015

Contract Pharmacy Representative

Riverside Health System
Cynthia Williams, VP/Chief Pharmacy Officer
(757) 784-1569

Signed By Date

10/15/2013