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WALGREEN CO.
CAH491302-00 CARILION GILES COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
CARILION GILES COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491302-00
Entity Address
159 HARTLEY WAY
PEARISBURG, VA 24134
Medicare Provider Number
491302
Participating Start Date
8/30/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01257
103 W COMMONWEALTH BLVD
MARTINSVILLE, VA 24112-1806
Pharmacy Comments
Contract Details
Approval Date
10/18/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William Flattery, VP Community Hospital, Administration
(540) 598-1933
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/18/2021
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