Contract Pharmacy Details

WALGREEN CO.
CH033100 CAMDEN-ON-GAULEY MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

CAMDEN-ON-GAULEY MEDICAL CENTER, INC.

Subdivision Name

CAMDEN-ON-GAULEY MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH033100

Entity Address

10003 Webster Rd
Camden On Gauley, WV 26208

Grant Number

H80CS00078

Participating Start Date

12/1/1992

Last Recertification Date

2/23/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

RITE AID #01687
306 N MAIN ST
WEBSTER SPRINGS, WV 26288

Pharmacy Comments

Contract Details

Approval Date

1/10/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/18/2020
Pharmacy closed

Contacts

Covered Entity Signing Official

Margaret Hickey, CEO
(304) 226-5725

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/10/2019

340B Drug Pricing Program Database