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WALGREEN CO.
DSH340107 East Carolina Health-Heritage, Inc. d/b/a ECU Health Edgecombe Hospital
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Covered Entity Details
Entity Name
East Carolina Health-Heritage, Inc. d/b/a ECU Health Edgecombe Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340107
Entity Address
111 HOSPITAL DRIVE
TARBORO, NC 27886
Medicare Provider Number
340107
Participating Start Date
7/1/2003
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA:WALGREENS #15475
1519 N. MAIN STREET
TARBORO, NC 27886
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
10/16/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charles Alford, Vice President, Financial Services
(252) 641-7131
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2023
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