Contract Pharmacy Details

WALGREEN CO.
CH060530 Community Health Centers Inc.

Covered Entity Details

Entity Name

Community Health Centers Inc.

Subdivision Name

COMMUNITY HEALTH CENTERS, INC.

Type

HRSA-Funded Health Center

340B ID

CH060530

Entity Address

12716 N.E. 36TH STREET
OKLAHOMA CITY, OK 73140-3589

Grant Number

H80CS00320

Participating Start Date

10/1/2017

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #11811
600 SHAWNEE MALL DR.
SHAWNEE, OK 74804-1322

Pharmacy Comments

Contract Details

Approval Date

4/2/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/30/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Isabella Lawson, Chief Executive Officer
(405) 769-3301 Ext: 1232

Contract Pharmacy Representative

Community Health Centers, Inc.
Isabella Lawson, Chief Executive Officer
(405) 769-3301 Ext: 1232

Signed By Date

4/2/2019

340B Drug Pricing Program Database