Contract Pharmacy Details

WALGREEN CO.
CH046680 RURAL HEALTH GROUP, INC.

Covered Entity Details

Entity Name

RURAL HEALTH GROUP, INC.

Subdivision Name

Rural Health Group at Jackson

Type

HRSA-Funded Health Center

340B ID

CH046680

Entity Address

9425 NC HIGHWAY 305
JACKSON, NC 27845-9679

Grant Number

H80CS00866

Participating Start Date

10/1/2003

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

RITE AID #11420
1825 EAST 10TH ST
ROANOKE RAPIDS, NC 27870

Pharmacy Comments

Contract Details

Approval Date

4/10/2018

Contract Begin Date

4/12/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/23/2018
Ownership change

Contacts

Covered Entity Signing Official

Yvonne Long-Gee, CEO
(252) 536-5820

Contract Pharmacy Representative

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

Signed By Date

4/10/2018

340B Drug Pricing Program Database