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WALGREEN CO.
CHC24142-10 HIGH COUNTRY COMMUNITY HEALTH
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Covered Entity Details
Entity Name
HIGH COUNTRY COMMUNITY HEALTH
Subdivision Name
East Burke HCCH
Type
HRSA-Funded Health Center
340B ID
CHC24142-10
Entity Address
560 Malcolm Blvd. STE B
Rutherford College, NC 28671
Grant Number
H80CS24142
Participating Start Date
7/1/2020
Last Recertification Date
2/1/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #17015
4059 NC HIGHWAY 105 S
SUGAR MOUNTAIN, NC 28604
Pharmacy Comments
Contract Details
Approval Date
4/22/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tiffany Melchers, CFO
(828) 262-3886 Ext: 120
Contract Pharmacy Representative
Walgreens
Andrea Koper, 340B Client Relations
(847) 964-6077
Signed By Date
4/15/2020
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