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WALGREEN CO.
CHC24149-00 MERCY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
MERCY HEALTH SERVICES, INC.
Subdivision Name
Mercy Health Services
Type
HRSA-Funded Health Center
340B ID
CHC24149-00
Entity Address
143 SE Parkway Ct
Franklin, TN 37064
Grant Number
H80CS24149
Participating Start Date
1/1/2013
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09510
758 ELLINGTON PKWY
LEWISBURG, TN 37091
Pharmacy Comments
Contract Details
Approval Date
1/7/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cindy J. Siler, CEO
(615) 790-0567 Ext: 200
Contract Pharmacy Representative
Walgreen Co.
Jeremy Mobley, 340B Client Advocate
(847) 964-8974
Signed By Date
1/7/2020
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