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HALIFAX PHARMACY
CH031525A PIEDMONT ACCESS TO HEALTH SERVICES INC
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Covered Entity Details
Entity Name
PIEDMONT ACCESS TO HEALTH SERVICES INC
Subdivision Name
PATHS Community Medical Center - DANVILLE
Type
HRSA-Funded Health Center
340B ID
CH031525A
Entity Address
705 Main St
Danville, VA 24541-1803
Grant Number
H80CS03972
Participating Start Date
10/1/2004
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
HALIFAX PHARMACY
Pharmacy Address
JOHN W BASS JR
4121 HALIFAX ROAD
SOUTH BOSTON, VA 24592
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Ownership change
Contacts
Covered Entity Signing Official
Robert A Pratt, Chief Operating Officer
(434) 791-3630 Ext: 1005
Contract Pharmacy Representative
Halifax Pharmacy
John Bass, President
(434) 575-0511
Signed By Date
10/16/2017
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