Contract Pharmacy Details

WALGREEN CO.
CH080730 METRO COMMUNITY PROVIDER NETWORK, INC.

Covered Entity Details

Entity Name

METRO COMMUNITY PROVIDER NETWORK, INC.

Subdivision Name

STRIDE CHC- Peoria

Type

HRSA-Funded Health Center

340B ID

CH080730

Entity Address

3292 Peoria St
Aurora, CO 80010

Grant Number

H80CS00217

Participating Start Date

12/1/1992

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06513
15301 E ILIFF AVE
AURORA, CO 80013

Pharmacy Comments

Contract Details

Approval Date

1/9/2019

Contract Begin Date

4/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/24/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Ben Wiederholt, CEO
(303) 761-1977 Ext: 1103

Contract Pharmacy Representative

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

Signed By Date

1/9/2019

340B Drug Pricing Program Database