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WALGREEN CO.
DSH340040 PITT COUNTY MEMORIAL HOSPITAL, INCORPORATED d/b/a ECU HEALTH MEDICAL CENTER
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Covered Entity Details
Entity Name
PITT COUNTY MEMORIAL HOSPITAL, INCORPORATED d/b/a ECU HEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340040
Entity Address
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Medicare Provider Number
340040
Participating Start Date
4/1/2003
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #17331
1560 US HIGHWAY 17
WILLIAMSTON, NC 27892
Pharmacy Comments
Contract Details
Approval Date
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jay Briley, President
(252) 847-5014
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2024
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