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WALGREEN CO.
CHC00132-00 RICHLAND MEDICAL CENTER INC
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Covered Entity Details
Entity Name
RICHLAND MEDICAL CENTER INC
Subdivision Name
Central Ozarks Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC00132-00
Entity Address
304 W Washington Ave
Richland, MO 65556-7101
Grant Number
H80CS00132
Participating Start Date
4/1/2016
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01142
3938 OSAGE BEACH PKWY
OSAGE BEACH, MO 65065-2146
Pharmacy Comments
Contract Details
Approval Date
7/12/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Stiles, CEO
(573) 765-5131 Ext: 320
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2016
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