Contract Pharmacy Details

WALGREEN CO.
FQHCLA377 OHIO STATE UNIVERSITY, THE

Covered Entity Details

Entity Name

OHIO STATE UNIVERSITY, THE

Subdivision Name

Ohio State University Total Health and Wellness

Type

Health Center Program Look-Alike

340B ID

FQHCLA377

Entity Address

181 Taylor Ave Ste 1203
Columbus, OH 43203

Grant Number

LALCS31123

Participating Start Date

1/1/2019

Last Recertification Date

1/29/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06273
3015 E LIVINGSTON AVE
COLUMBUS, OH 43209-3047

Pharmacy Comments

Contract Details

Approval Date

10/15/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Candy Sue Rinehart, CEO
(614) 685-9994

Contract Pharmacy Representative

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

Signed By Date

10/15/2018

340B Drug Pricing Program Database