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WALGREEN EASTERN CO., INC.
RRC330126-00 Garnet Health Medical Center
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Covered Entity Details
Entity Name
Garnet Health Medical Center
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330126-00
Entity Address
707 E MAIN STREET
MIDDLETOWN, NY 10940-2650
Medicare Provider Number
330126
Participating Start Date
1/29/2021
Last Recertification Date
9/11/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #19500
76 PIKE ST
PORT JERVIS, NY 12771
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maria Russo, Director of Pharmacy
(845) 333-2043
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/13/2022
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