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WALGREEN EASTERN CO., INC.
CH012230 WOOD RIVER HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
WOOD RIVER HEALTH SERVICES, INC.
Subdivision Name
WOOD RIVER HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH012230
Entity Address
823 Main St
Hope Valley, RI 02832-1920
Grant Number
H80CS00059
Participating Start Date
10/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #11128
875 TIOGUE AVE.
COVENTRY, RI 02816-6300
Pharmacy Comments
Contract Details
Approval Date
3/4/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHAEL A. LICHTENSTEIN, President & CEO
(401) 387-9648
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2013
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