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WALGREEN CO.
CH041349E East Tennessee State University
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Covered Entity Details
Entity Name
East Tennessee State University
Subdivision Name
JOHNSON CITY DOWNTOWN DAY CENTER
Type
HRSA-Funded Health Center
340B ID
CH041349E
Entity Address
202 W Fairview Ave
Johnson City, TN 37604
Grant Number
H80CS00840
Participating Start Date
4/1/2018
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #13891
429 N. STATE OF FRANKLIN RD.
JOHNSON CITY, TN 37604
Pharmacy Comments
Contract Details
Approval Date
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Melissa Queen, Business Director
(423) 439-4076
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/12/2024
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