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WALGREEN CO.
CH046810 RURAL MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
RURAL MEDICAL SERVICES, INC.
Subdivision Name
Corporate Office
Type
HRSA-Funded Health Center
340B ID
CH046810
Entity Address
207 Murray Drive
Newport, TN 37821-9032
Grant Number
H80CS00406
Participating Start Date
7/1/2018
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #21215
309C 22ND AVE N
NASHVILLE, TN 37203
Pharmacy Comments
Contract Details
Approval Date
4/21/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
LARRY STANIFER, CEO
(423) 613-3300
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/21/2017
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