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WALGREEN CO.
CH053060 Sixteenth Street Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Sixteenth Street Community Health Centers, Inc.
Subdivision Name
Sixteenth Street Community Health Centers-Chavez
Type
HRSA-Funded Health Center
340B ID
CH053060
Entity Address
1032 S Cesar E Chavez Dr
MILWAUKEE, WI 53204
Grant Number
H80CS00593
Participating Start Date
10/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04887
9449 S HOWELL AVE
OAK CREEK, WI 53154
Pharmacy Comments
Contract Details
Approval Date
7/11/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Maschek, Vice President Finance and Strategy
(414) 897-5156
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/11/2019
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