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WALGREEN CO.
CH0412790 RURAL HEALTH SERVICES CONSORTIUM
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Covered Entity Details
Entity Name
RURAL HEALTH SERVICES CONSORTIUM
Subdivision Name
HAWKINS MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH0412790
Entity Address
4966 HIGHWAY 11 WEST
ROGERSVILLE, TN 37857
Grant Number
H80CS00421
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
RITE AID #00114
1252 NORTH MAIN STREET
ERWIN, TN 37650
Pharmacy Comments
Contract Details
Approval Date
1/3/2018
Contract Begin Date
1/4/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/9/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
LINDA W. BUCK, CHIEF EXECUTIVE OFFICER
(423) 272-9163 Ext: 8901
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/3/2018
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