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WALGREEN CO.
CH04102P Greene County Health Care, Incorporated
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Covered Entity Details
Entity Name
Greene County Health Care, Incorporated
Subdivision Name
Mobile Dental Van
Type
HRSA-Funded Health Center
340B ID
CH04102P
Entity Address
261 Belvoir Highway
Greenville, NC 27834-8193
Grant Number
H80CS00088
Participating Start Date
7/1/2018
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #17018
5016 OLD TAR RD
WINTERVILLE, NC 28590
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vito Veneruso, Chief Operating Officer
(252) 253-0962
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2023
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