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WALGREEN CO.
RWII27536 Warren-Vance Community Health Center
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Covered Entity Details
Entity Name
Warren-Vance Community Health Center
Subdivision Name
Northern Outreach Clinic
Type
Ryan White Part B
340B ID
RWII27536
Entity Address
120 Charles Rollins Rd. Suite 205
Henderson, NC 27536
Grant Number
X07HA00051
Participating Start Date
1/1/2012
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #19096
201 TRADE ST
HENDERSON, NC 27536
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle Collins Ogle, Medical Director
(252) 572-2610
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/17/2018
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