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WALGREEN EASTERN CO., INC.
CH011820 THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
THUNDERMIST DENTAL ADMIN WOONSOCKET
Type
HRSA-Funded Health Center
340B ID
CH011820
Entity Address
25 John A. Cummings Way
Woonsocket, RI 02895-3240
Grant Number
H80CS00454
Participating Start Date
10/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #18384
456 BRANCH AVE.
PROVIDENCE, RI 02904-2205
Pharmacy Comments
Contract Details
Approval Date
4/8/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/10/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Jeanne LaChance, President/CEO
(401) 767-4100 Ext: 3015
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/8/2019
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