340B Drug Pricing Program Database
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WALGREEN CO.
CH04681C RURAL MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
RURAL MEDICAL SERVICES, INC.
Subdivision Name
GRASSY FORK CENTER
Type
HRSA-Funded Health Center
340B ID
CH04681C
Entity Address
4261 Big Creek Rd
Hartford, TN 37753-2220
Grant Number
H80CS00406
Participating Start Date
7/1/2002
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 10688
102 E BROADWAY
NEWPORT, TN 37821-2323
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LARRY STANIFER, CEO
(423) 613-3300
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2019
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