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WALGREEN CO.
CHC24142-03 HIGH COUNTRY COMMUNITY HEALTH
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Covered Entity Details
Entity Name
HIGH COUNTRY COMMUNITY HEALTH
Subdivision Name
Avery Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CHC24142-03
Entity Address
504 PINEOLA ST
NEWLAND, NC 28657-7604
Grant Number
H80CS24142
Participating Start Date
1/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #18327
103 NORTH SHADY STREET
MOUNTAIN CITY, TN 37683
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alice Salthouse, CEO
(828) 262-3886 Ext: 127
Contract Pharmacy Representative
Walgreens
Joyce Abraham, Analyst, 340B Client Relationship
(847) 964-6382
Signed By Date
1/13/2022
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