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WALGREEN EASTERN CO., INC.
CH021790 HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Hudson Headwaters Administrative Offices
Type
HRSA-Funded Health Center
340B ID
CH021790
Entity Address
9 CAREY ROAD
QUEENSBURY, NY 12804
Grant Number
H80CS00159
Participating Start Date
4/1/2001
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #10591
305 W. MAIN ST.
MALONE, NY 12953-1751
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/6/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Laura Pasco, EVP, Chief Financial Officer
(518) 761-0300 Ext: 31553
Contract Pharmacy Representative
Walgreen Co.
Enrique Anza, Sr. Analyst, 340B Client Relationship
(847) 964-6160
Signed By Date
1/14/2025
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