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WALGREEN CO.
CHC08748-06 COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI
Subdivision Name
Community Health Center of Central Missouri - Christy Drive
Type
HRSA-Funded Health Center
340B ID
CHC08748-06
Entity Address
1511 Christy Drive
Jefferson City, MO 65101-2854
Grant Number
H80CS08748
Participating Start Date
7/1/2018
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09713
3740 W TRUMAN BLVD
JEFFERSON CITY, MO 65109-0537
Pharmacy Comments
Contract Details
Approval Date
9/7/2018
Contract Begin Date
9/7/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Toby Barnett, CFO
(573) 632-0243
Contract Pharmacy Representative
Walgreens
Kaenye Prince, Analyst
(847) 964-8027
Signed By Date
9/7/2018
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