Contract Pharmacy Details

WALGREEN CO.
CH04681A RURAL MEDICAL SERVICES, INC.

Covered Entity Details

Entity Name

RURAL MEDICAL SERVICES, INC.

Subdivision Name

PARROTTSVILLE CENTER

Type

HRSA-Funded Health Center

340B ID

CH04681A

Entity Address

111 Mockingbird Ave
Parrottsville, TN 37843-2741

Grant Number

H80CS00406

Participating Start Date

12/1/1992

Last Recertification Date

2/24/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #11813
251 S CUMBERLAND ST
MORRISTOWN, TN 37813

Pharmacy Comments

Contract Details

Approval Date

3/22/2018

Contract Begin Date

3/22/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

LARRY STANIFER, CEO
(423) 613-3300

Contract Pharmacy Representative

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

Signed By Date

3/22/2018

340B Drug Pricing Program Database