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WALGREEN CO.
CH04123I OCOEE REGIONAL HEALTH CORPORATION
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Covered Entity Details
Entity Name
OCOEE REGIONAL HEALTH CORPORATION
Subdivision Name
BENTON FAMILY HEALTH CARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH04123I
Entity Address
6784 HWY 411
BENTON, TN 37307-4818
Grant Number
H80CS00762
Participating Start Date
7/1/2015
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04201
35 25TH STREET NW
CLEVELAND, TN 37311
Pharmacy Comments
Contract Details
Approval Date
4/13/2023
Contract Begin Date
4/17/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BILL MOATS, CEO
(423) 338-8995 Ext: 1212
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/13/2023
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