Contract Pharmacy Details

WALGREEN CO.
CH059700 Central Counties Health Centers, Inc.

Covered Entity Details

Entity Name

Central Counties Health Centers, Inc.

Subdivision Name

Capitol Community Health Center

Type

HRSA-Funded Health Center

340B ID

CH059700

Entity Address

2239 E Cook St
Springfield, IL 62703-1944

Grant Number

H80CS00533

Participating Start Date

4/1/2000

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 01770
2625 STEVENSON DR
SPRINGFIELD, IL 62703-4327

Pharmacy Comments

Contract Details

Approval Date

12/21/2012

Contract Begin Date

12/21/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

CRAIG CLOVER, PRESIDENT & CEO
(217) 788-2311

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

12/21/2012

340B Drug Pricing Program Database