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Walgreens Central Fill #21400
CH01064D NORTHERN COUNTIES HEALTH CARE, INC
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Covered Entity Details
Entity Name
NORTHERN COUNTIES HEALTH CARE, INC
Subdivision Name
DANVILLE HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH01064D
Entity Address
26 Cedar Ln
Danville, VT 05828
Grant Number
H80CS00632
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
Walgreens Central Fill #21400
Pharmacy Address
44 Cabot Blvd.
Mansfield, MA 02048
Pharmacy Comments
Contract Details
Approval Date
4/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Angela Neil, CFO
(802) 748-9405 Ext: 1599
Contract Pharmacy Representative
Walgreen Co.
Nicholas Covarrubias, Analyst
(847) 527-3072
Signed By Date
4/3/2023
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