Contract Pharmacy Details

WALGREEN CO.
CH033130 E.A. HAWSE HEALTH CENTER, INC.

Covered Entity Details

Entity Name

E.A. HAWSE HEALTH CENTER, INC.

Subdivision Name

Central Office

Type

HRSA-Funded Health Center

340B ID

CH033130

Entity Address

17978 STATE ROUTE 55
BAKER, WV 26801-0097

Grant Number

H80CS00563

Participating Start Date

10/1/2004

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: MY PHARMACY
781 CHESTNUT RIDGE ROAD
MORGANTOWN, WV 26505

Pharmacy Comments

Contract Details

Approval Date

4/16/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/27/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

GARY T. JOHNSON, CEO
(304) 897-5915 Ext: 230

Contract Pharmacy Representative

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

Signed By Date

4/16/2018

340B Drug Pricing Program Database