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DELIVERCARERX PHARMACY LLC
CH034050 BLUE RIDGE MEDICAL CENTER INC
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Covered Entity Details
Entity Name
BLUE RIDGE MEDICAL CENTER INC
Subdivision Name
BLUE RIDGE MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH034050
Entity Address
4038 Thomas Nelson Hwy
Arrington, VA 22922-2302
Grant Number
H80CS00175
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
DELIVERCARERX PHARMACY LLC
Pharmacy Address
DELIVERCARERX PHARMACY LLC
1471 E BUSINESS CENTER DR
STE 200
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
4/9/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/11/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Randolph Pirtle, CEO
(434) 263-4000
Contract Pharmacy Representative
Agape
Dave Krishna, CEO
(847) 965-1600
Signed By Date
4/9/2018
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