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HILL CITY PHARMACY INCORPORATED
FQHCLA350B Community Access Network, Inc.
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Covered Entity Details
Entity Name
Community Access Network, Inc.
Subdivision Name
Tate Springs Road
Type
Health Center Program Look-Alike
340B ID
FQHCLA350B
Entity Address
1900 Tate Springs Road Suite 3
Lynchburg, VA 24501-1122
Grant Number
LALCS31106
Participating Start Date
1/1/2018
Last Recertification Date
1/29/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
HILL CITY PHARMACY INCORPORATED
Pharmacy Address
800 5TH ST STE B
LYNCHBURG, VA 24504-2848
Pharmacy Comments
Contract Details
Approval Date
12/27/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Christina Delzingaro, CEO
(434) 200-3366
Contract Pharmacy Representative
Hill City Pharmacy
Bryan Moody, Owner
(434) 237-2221
Signed By Date
12/27/2017
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