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WALGREEN EASTERN CO., INC.
RRC330164-00 HIGHLAND HOSPITAL OF ROCHESTER
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Covered Entity Details
Entity Name
HIGHLAND HOSPITAL OF ROCHESTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330164-00
Entity Address
1000 South Avenue
ROCHESTER, NY 14620
Medicare Provider Number
330164
Participating Start Date
4/1/2017
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 10511
2665 E HENRIETTA RD
HENRIETTA, NY 14467
Pharmacy Comments
Contract Details
Approval Date
10/17/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Segerson, Director of Finance
(585) 341-6686
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/17/2017
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