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WALGREEN CO
FQHCLA447A TRINITY FAMILY HEALTH, INC
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Covered Entity Details
Entity Name
TRINITY FAMILY HEALTH, INC
Subdivision Name
Trinity Family Health Primary Care - Corbin
Type
Health Center Program Look-Alike
340B ID
FQHCLA447A
Entity Address
14949 N US Highway 25 E STE 3
Corbin, KY 40701-6285
Grant Number
LALCS49105
Participating Start Date
10/1/2023
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #12152
1775 HIGHWAY 192 W
LONDON, KY 40741
Pharmacy Comments
Contract Details
Approval Date
1/10/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dylan Day, Chief Operating Officer
(606) 515-2324
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/10/2024
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