Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CAH331318-00 Carthage Area Hospital, Inc.

Covered Entity Details

Entity Name

Carthage Area Hospital, Inc.

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH331318-00

Entity Address

1001 West Street
Carthage, NY 13619

Medicare Provider Number

331318

Participating Start Date

1/1/2015

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

DBA: WALGREENS # 10239
1655 STATE ST
WATERTOWN, NY 13601-3555

Pharmacy Comments

Contract Details

Approval Date

1/14/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/13/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Rich Duvall, CEO
(315) 519-5201

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/14/2018

340B Drug Pricing Program Database