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WALGREEN CO
CHC08749-00 MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
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Covered Entity Details
Entity Name
MARTINSVILLE HENRY COUNTY COALITION FOR HEALTH AND WELLNESS
Subdivision Name
Bassett Family Practice
Type
HRSA-Funded Health Center
340B ID
CHC08749-00
Entity Address
324 T B Stanley Hwy
Bassett, VA 24055-6108
Grant Number
H80CS08749
Participating Start Date
1/1/2010
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #12017
3590 VIRGINIA AVE
COLLINSVILLE, VA 24078
Pharmacy Comments
Contract Details
Approval Date
5/2/2012
Contract Begin Date
5/2/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BARBARA JACKMAN, EXECUTIVE DIRECTOR
(276) 403-5099
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
5/4/2012
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