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WALGREENS SPECIALTY PHARMACY, LLC
CH012230 WOOD RIVER HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
WOOD RIVER HEALTH SERVICES, INC.
Subdivision Name
WOOD RIVER HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH012230
Entity Address
823 Main St
Hope Valley, RI 02832-1920
Grant Number
H80CS00059
Participating Start Date
10/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
4/6/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alison Croke, President and CEO
(401) 539-2461 Ext: 148
Contract Pharmacy Representative
Wood River Health Servives
Edward Smith, CFO
(443) 801-4871
Signed By Date
4/6/2022
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