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WALGREEN EASTERN CO., INC.
CHC26642-00 FIVE-TOWN HEALTH ALLIANCE, INC.
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Covered Entity Details
Entity Name
FIVE-TOWN HEALTH ALLIANCE, INC.
Subdivision Name
Mountain Community Health
Type
HRSA-Funded Health Center
340B ID
CHC26642-00
Entity Address
61 Pine St Bldg 4
BRISTOL, VT 05443
Grant Number
H80CS26642
Participating Start Date
1/1/2014
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #18375
263 COURT ST
MIDDLEBURY, VT 05753
Pharmacy Comments
Contract Details
Approval Date
10/9/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Martha A. Halnon, CEO
(802) 453-5116
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/9/2018
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