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WALGREEN CO.
CHC09959-00 GRACE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GRACE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Grace Community Health Center, Inc
Type
HRSA-Funded Health Center
340B ID
CHC09959-00
Entity Address
39 Cumberland Gap Plaza
Gray, KY 40734
Grant Number
H80CS09959
Participating Start Date
10/1/2010
Last Recertification Date
2/1/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #18950
248 S. MAIN ST
JELLICO, TN 37762
Pharmacy Comments
Contract Details
Approval Date
10/8/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/7/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Michael W Stanley, Chief Executive Officer
(606) 526-9005
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/8/2022
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