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WALGREEN CO.
CH031000 TUG RIVER HEALTH ASSOCIATION, INC
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Covered Entity Details
Entity Name
TUG RIVER HEALTH ASSOCIATION, INC
Subdivision Name
TUG RIVER HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH031000
Entity Address
5883 Black Diamond Highway
GARY, WV 24836-0507
Grant Number
H80CS00701
Participating Start Date
10/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #17496
4248 COAL HERITAGE RD
BLUEFIELD, WV 24701-9190
Pharmacy Comments
Contract Details
Approval Date
4/1/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/7/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Tim Crofton, CEO
(304) 448-2101
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/1/2019
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