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WALGREEN CO.
CH059840 WHITESIDE, COUNTY OF
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Covered Entity Details
Entity Name
WHITESIDE, COUNTY OF
Subdivision Name
WHITESIDE CHD - ROCK FALLS
Type
HRSA-Funded Health Center
340B ID
CH059840
Entity Address
1300 W 2nd St
Rock Falls, IL 61071-1005
Grant Number
H80CS06660
Participating Start Date
7/1/2006
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05144
1905 N 2ND ST
CLINTON, IA 52732
Pharmacy Comments
Contract Details
Approval Date
10/11/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BETH FIORINI, CEO
(815) 626-2230 Ext: 1206
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/11/2018
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