Contract Pharmacy Details

WALGREEN CO.
CH045050 SANDHILLS MEDICAL FOUNDATION, INC.

Covered Entity Details

Entity Name

SANDHILLS MEDICAL FOUNDATION, INC.

Subdivision Name

SANDHILLS MEDICAL FOUNDATION Inc. - Jefferson Site

Type

HRSA-Funded Health Center

340B ID

CH045050

Entity Address

409 E Church St
Jefferson, SC 29718-8701

Grant Number

H80CS00501

Participating Start Date

10/1/2001

Last Recertification Date

2/26/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 10227
175 FORUM DRIVE
COLUMBIA, SC 29229-7939

Pharmacy Comments

Contract Details

Approval Date

11/18/2011

Contract Begin Date

11/18/2011

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Alyssa Norwood, Director of Pharmacy
(803) 408-3262

Contract Pharmacy Representative

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

Signed By Date

11/17/2011

340B Drug Pricing Program Database