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WALGREEN EASTERN CO., INC.
CH02056R Mosaic Health, Inc.
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Covered Entity Details
Entity Name
Mosaic Health, Inc.
Subdivision Name
Mosaic Health Rushville
Type
HRSA-Funded Health Center
340B ID
CH02056R
Entity Address
2 Rubin Dr
Rushville, NY 14544-9681
Grant Number
H80CS00167
Participating Start Date
4/1/2007
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #11716
321 W. WASHINGTON ST.
BATH, NY 14810-1017
Pharmacy Comments
Contract Details
Approval Date
8/22/2012
Contract Begin Date
8/22/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/9/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michael J Leary, President/CEO
(585) 325-2280 Ext: 7302
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
8/17/2012
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