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WALGREEN CO
CH067230 HIDALGO MEDICAL SERVICES, INC
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Covered Entity Details
Entity Name
HIDALGO MEDICAL SERVICES, INC
Subdivision Name
HIDALGO MEDICAL SERVICES
Type
HRSA-Funded Health Center
340B ID
CH067230
Entity Address
530 De Moss St
Lordsburg, NM 88045-2618
Grant Number
H80CS00744
Participating Start Date
10/1/2001
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS
2370 E MAIN STREET
WOODLAND, CA 95776
Pharmacy Comments
Contract Details
Approval Date
8/27/2012
Contract Begin Date
8/27/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Forrest N. Olson, CEO
(575) 519-2739
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
8/27/2012
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