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WALGREEN CO.
CHC330723-00 UNIVERSITY OF WYOMING
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Covered Entity Details
Entity Name
UNIVERSITY OF WYOMING
Subdivision Name
University of Wyoming Family Medicine Residency Casper
Type
HRSA-Funded Health Center
340B ID
CHC330723-00
Entity Address
1522 E A St
Casper, WY 82601-2217
Grant Number
H80CS30723
Participating Start Date
10/1/2017
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #21243
327 W 3RD AVE
STE A
SPOKANE, WA 99201
Pharmacy Comments
Contract Details
Approval Date
10/23/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diana Grant Hulme, Associate Vice President Research
(307) 766-6811
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/23/2018
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