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WALGREEN EASTERN CO., INC.
CH021510 Sun River Health, Inc.
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Covered Entity Details
Entity Name
Sun River Health, Inc.
Subdivision Name
Sun River Health Peekskill
Type
HRSA-Funded Health Center
340B ID
CH021510
Entity Address
1037 Main St
Peekskill, NY 10566-2913
Grant Number
H80CS00313
Participating Start Date
12/1/1992
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 05956
275 BROADWAY
AMITYVILLE, NY 11701
Pharmacy Comments
Contract Details
Approval Date
7/24/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allison Dubois-Adach, COO
(914) 734-8503
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/24/2014
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