Contract Pharmacy Details

WALGREEN CO.
CHC08238-00 CHANGE, INCORPORATED

Covered Entity Details

Entity Name

CHANGE, INCORPORATED

Subdivision Name

Family Medical Care Community Health Center - Hancock County

Type

HRSA-Funded Health Center

340B ID

CHC08238-00

Entity Address

3136 West St
Weirton, WV 26062-4637

Grant Number

H80CS08238

Participating Start Date

4/1/2007

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #19991
126 12TH ST.
WELLSBURG, WV 26070-1572

Pharmacy Comments

Contract Details

Approval Date

4/3/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Judy Raveaux, CEO
(304) 797-7733 Ext: 1311

Contract Pharmacy Representative

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

Signed By Date

4/3/2019

340B Drug Pricing Program Database