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WALGREEN CO.
CH050990 HEALTHSOURCE OF OHIO, INC.
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Covered Entity Details
Entity Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HEALTHSOURCE OF OHIO, INC.
Type
HRSA-Funded Health Center
340B ID
CH050990
Entity Address
424 WARDS CORNER STE 200
LOVELAND, OH 45140-6966
Grant Number
H80CS00201
Participating Start Date
10/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11294
1070 WESTERN AVE.
CHILLICOTHE, OH 45601-1174
Pharmacy Comments
01/27/2012 changed CP name (was Walgreens Pharmacy #11284)
Contract Details
Approval Date
9/20/2011
Contract Begin Date
9/20/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/14/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William Marois, CFO
(513) 576-7700
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
8/12/2011
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