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GOOLRICK'S PHARMACY
RWII22401 FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES INC.
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Covered Entity Details
Entity Name
FREDERICKSBURG AREA HEALTH AND SUPPORT SERVICES INC.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII22401
Entity Address
4343 Plank Road
Suite 100
FREDERICKSBURG, VA 22407
Grant Number
X07HA00009
Participating Start Date
4/1/2011
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GOOLRICK'S PHARMACY
Pharmacy Address
SMOKEYRUN, LLC
901 CAROLINE ST
FREDERICKSBURG, VA 22401-5807
Pharmacy Comments
Contract Details
Approval Date
4/19/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen James Clark, Grants Manager
(540) 371-7532 Ext: 123
Contract Pharmacy Representative
Goolrick's Pharmacy
Christopher Conder, Owner
(540) 373-3411
Signed By Date
4/19/2018
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