340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO
CH08165S Clinica Campesina Family Health Services
Print
Covered Entity Details
Entity Name
Clinica Campesina Family Health Services
Subdivision Name
Clinica Family Health - Lafayette
Type
HRSA-Funded Health Center
340B ID
CH08165S
Entity Address
1735 S Public Rd
Lafayette, CO 80026
Grant Number
H80CS00690
Participating Start Date
7/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA; WALGREENS #11327
450 KEN PRATT BLVD
LONGMONT, CO 80501
Pharmacy Comments
Contract Details
Approval Date
10/8/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Simon Smith, CEO
(303) 665-3036 Ext: 1003
Contract Pharmacy Representative
Walgreens
Tony Joe Chriscoe, 340 Client Relations Analyst
(847) 315-5806
Signed By Date
10/8/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session