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WALGREEN CO.
CHC24149-16 MERCY HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
MERCY HEALTH SERVICES, INC.
Subdivision Name
Mercy office at Marshall Elementary School
Type
HRSA-Funded Health Center
340B ID
CHC24149-16
Entity Address
401 Tiger Blvd
Lewisburg, TN 37091-2070
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 # 09510
758 ELLINGTON PKWY
LEWISBURG, TN 37091
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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