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WALGREEN EASTERN CO., INC.
RRC330164-00 HIGHLAND HOSPITAL OF ROCHESTER
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Covered Entity Details
Entity Name
HIGHLAND HOSPITAL OF ROCHESTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330164-00
Entity Address
1000 South Avenue
ROCHESTER, NY 14620
Medicare Provider Number
330164
Participating Start Date
4/1/2017
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #19585
792 W MAIN ST
ROCHESTER, NY 14611
Pharmacy Comments
Contract Details
Approval Date
7/3/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/12/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Kevin Segerson, Director of Finance
(585) 341-6686
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/3/2018
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