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WALGREEN CO.
CH045050 SANDHILLS MEDICAL FOUNDATION, INC.
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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
WALGREENS #16396
805 PAMPLICO HWY.
SUITE B-130
FLORENCE, SC 29505
Pharmacy Comments
Contract Details
Approval Date
7/14/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/8/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Christopher W. Dixon, CEO
(843) 335-6754
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2017
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