340B Drug Pricing Program Database
WALGREEN CO.
FQHCLA329 UNIVERSITY OF WYOMING - information as of 5/3/2025 11:42:28 PM
Covered Entity Details
Entity Name
UNIVERSITY OF WYOMING
Subdivision Name
University of Wyoming Family Medicine Residency Cheyenne
Type
Health Center Program Look-Alike
340B ID
FQHCLA329
Entity Address
821 E 18th St
Cheyenne, WY 82001-4775
Grant Number
LALCS00162
Participating Start Date
1/1/2015
Last Recertification Date
2/14/2017
Entity Termination Date
10/1/2017
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09548
1501 DELL RANGE BLVD
CHEYENNE, WY 82009-4853
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/17/2017
Agreement registered in error
Contacts
Covered Entity Signing Official
Dorothy C. Yates, Associate Vice President for Research & Economic Development
(307) 766-5320
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/17/2017
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