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WALGREEN CO.
CH03099A Monroe County Health Center
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Covered Entity Details
Entity Name
Monroe County Health Center
Subdivision Name
PETERSTOWN CLINIC
Type
HRSA-Funded Health Center
340B ID
CH03099A
Entity Address
2869 Seneca Trail South
PETERSTOWN, WV 24963-0580
Grant Number
H80CS00384
Participating Start Date
4/1/2004
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #17869
121 N MAIN STREET
PEARISBURG, VA 24134-1624
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jim Nelson, CEO
(304) 772-3064 Ext: 129
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2019
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