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WALGREEN EASTERN CO., INC.
CH02179AH HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Family Health at Malone
Type
HRSA-Funded Health Center
340B ID
CH02179AH
Entity Address
16 3rd Street STE A
Malone, NY 12953-1367
Grant Number
H80CS00159
Participating Start Date
4/1/2024
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS
301 CORNELIA ST.
PLATTSBURGH, NY 12901-2523
Pharmacy Comments
Contract Details
Approval Date
4/13/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
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
4/13/2025
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