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WALGREEN CO.
CH041279E RURAL HEALTH SERVICES CONSORTIUM, INC.
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Covered Entity Details
Entity Name
RURAL HEALTH SERVICES CONSORTIUM, INC.
Subdivision Name
BAILEYTON MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH041279E
Entity Address
580 Van Hill Rd
Greeneville, TN 37745-7608
Grant Number
H80CS00421
Participating Start Date
4/1/1999
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05828
1420 W STONE DR
KINGSPORT, TN 37660
Pharmacy Comments
Contract Details
Approval Date
5/3/2023
Contract Begin Date
5/4/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LINDA W. BUCK, CHIEF EXECUTIVE OFFICER
(423) 272-9163 Ext: 8901
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
5/3/2023
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