Contract Pharmacy Details

WALGREEN CO.
CH03301H THREE LOWER COUNTIES COMMUNITY SERVICES, INC.

Covered Entity Details

Entity Name

THREE LOWER COUNTIES COMMUNITY SERVICES, INC.

Subdivision Name

THREE LOWER COUNTIES COMMUNITY SVCS INC

Type

HRSA-Funded Health Center

340B ID

CH03301H

Entity Address

12145 Elm St
Princess Anne, MD 21853-1358

Grant Number

H80CS00774

Participating Start Date

4/1/2007

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #12130
909 MT. HERMON RD.
SALISBURY, MD 21804

Pharmacy Comments

Contract Details

Approval Date

4/14/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/30/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Susanne Gray, CEO/President
(410) 749-1015

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/14/2014

340B Drug Pricing Program Database