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WALGREEN CO.
CH086120 COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER OF CENTRAL WYOMING, INC.
Subdivision Name
Community Health Center of Central Wyoming
Type
HRSA-Funded Health Center
340B ID
CH086120
Entity Address
5000 Blackmore Road
Casper, WY 82609
Grant Number
H80CS00564
Participating Start Date
1/1/2001
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07462
190 SE WYOMING BLVD
CASPER, WY 82609
Pharmacy Comments
Contract Details
Approval Date
7/7/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cole White, CEO
(307) 233-6000
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/7/2017
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