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WALGREEN CO.
CHC24149-05 MERCY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
MERCY HEALTH SERVICES, INC.
Subdivision Name
Mercy office at Marshall Co Oak Grove Elementary
Type
HRSA-Funded Health Center
340B ID
CHC24149-05
Entity Address
1645 Franklin Pike
Lewisburg, TN 37091-6916
Grant Number
H80CS24149
Participating Start Date
1/1/2025
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01989
4932 MAIN STREET
SPRING HILL, TN 37174-8262
Pharmacy Comments
Contract Details
Approval Date
11/12/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rhonda Sizemore, CFO
(615) 790-0567 Ext: 206
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
11/7/2024
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