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WALGREEN CO.
CHC28973-00 GENESIS HEALTHCARE, INC
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Covered Entity Details
Entity Name
GENESIS HEALTHCARE, INC
Subdivision Name
Olanta Family Care
Type
HRSA-Funded Health Center
340B ID
CHC28973-00
Entity Address
211 S Jones Rd
Olanta, SC 29114-9705
Grant Number
H80CS28973
Participating Start Date
6/27/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06262
3501 FOREST DRIVE
COLUMBIA, SC 29204-4003
Pharmacy Comments
Contract Details
Approval Date
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/27/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Tony R. Megna, CEO
(803) 254-3676
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/13/2017
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