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WALGREEN EASTERN CO., INC.
CH01182N THUNDERMIST HEALTH CENTER
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Covered Entity Details
Entity Name
THUNDERMIST HEALTH CENTER
Subdivision Name
THUNDERMIST WEST WARWICK
Type
HRSA-Funded Health Center
340B ID
CH01182N
Entity Address
186 Providence St
West Warwick, RI 02893
Grant Number
H80CS00454
Participating Start Date
7/1/2007
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #15538
335 PRAIRIE AVENUE
PROVIDENCE, RI 02905
Pharmacy Comments
Contract Details
Approval Date
4/12/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeanne LaChance, President/CEO
(401) 767-4100 Ext: 3015
Contract Pharmacy Representative
Walgreen CO.
Ruben Gonzales, Analyst
(847) 964-8686
Signed By Date
4/12/2018
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