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WALGREEN CO.
CH045800 GOSHEN MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
GOSHEN MEDICAL CENTER, INC.
Subdivision Name
GOSHEN MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH045800
Entity Address
444 SW Center St
Faison, NC 28341
Grant Number
H80CS00181
Participating Start Date
7/1/2003
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12895
1501 W. CUMBERLAND ST.
DUNN, NC 28334
Pharmacy Comments
Contract Details
Approval Date
4/3/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GREG BOUNDS, CEO
(910) 267-1942 Ext: 1117
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/3/2019
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