340B Drug Pricing Program Database
WALGREEN CO.
CH03224S PENINSULA INSTITUTE FOR COMMUNITY HEALTH, INC - information as of 5/6/2025 12:49:51 AM
Covered Entity Details
Entity Name
PENINSULA INSTITUTE FOR COMMUNITY HEALTH, INC
Subdivision Name
Hampton Newport News Community Services Board
Type
HRSA-Funded Health Center
340B ID
CH03224S
Entity Address
300 Medical Dr
Hampton, VA 23666-1765
Grant Number
H80CS00073
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04617
919 W MERCURY BLVD
HAMPTON, VA 23666
Pharmacy Comments
Contract Details
Approval Date
4/7/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Stephanie Gomez, 340B Operations Analyst
(847) 964-8785
Signed By Date
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