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WALGREEN EASTERN CO., INC.
CH01182P THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
Thundermist Special Populations Providence
Type
HRSA-Funded Health Center
340B ID
CH01182P
Entity Address
557 Broad Street
Providence, RI 02907-1403
Grant Number
H80CS00454
Participating Start Date
4/1/2016
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #19165
900 VICTORY HWY # 21
PO BOX 713
NORTH SMITHFIELD, RI 02896
Pharmacy Comments
Contract Details
Approval Date
7/12/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeanne LaChance, President/CEO
(401) 767-4100 Ext: 3015
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2018
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