Contract Pharmacy Details

WALGREEN CO.
CH048980 LEWIS COUNTY PRIMARY CARE CENTER, INC.

Covered Entity Details

Entity Name

LEWIS COUNTY PRIMARY CARE CENTER, INC.

Subdivision Name

Lewis County Primary Care Center, Inc.

Type

HRSA-Funded Health Center

340B ID

CH048980

Entity Address

211 KY 59
Building A
VANCEBURG, KY 41179

Grant Number

H80CS00106

Participating Start Date

1/1/1999

Last Recertification Date

2/26/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #18010
380 W MAIN ST
MOREHEAD, KY 40351

Pharmacy Comments

Contract Details

Approval Date

4/2/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JERRY UGRIN, CEO
(606) 796-3029

Contract Pharmacy Representative

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

Signed By Date

4/2/2019

340B Drug Pricing Program Database