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WALGREEN CO.
CH05099X HEALTHSOURCE OF OHIO, INC.
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Covered Entity Details
Entity Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HealthSource Wilmington
Type
HRSA-Funded Health Center
340B ID
CH05099X
Entity Address
140 W Main St
Wilmington, OH 45177-2239
Grant Number
H80CS00201
Participating Start Date
1/1/2012
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12372
1240 COLUMBUS AVE.
WASHINGTON COURT HOUSE, OH 43160-1655
Pharmacy Comments
Contract Details
Approval Date
7/9/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Jackson, VP of Marketing and Development
(513) 576-7700
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/9/2024
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