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WALGREEN CO.
CHC12854-00 HealthCore Clinic Inc
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Covered Entity Details
Entity Name
HealthCore Clinic Inc
Subdivision Name
HealthCore Clinic Inc
Type
HRSA-Funded Health Center
340B ID
CHC12854-00
Entity Address
2707 E 21st St N
Wichita, KS 67214-2249
Grant Number
H80CS12854
Participating Start Date
1/1/2010
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06170
555 N MAIZE ROAD
WICHITA, KS 67212
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
TERESA LOVELADY, CHIEF EXECUTIVE OFFICER
(316) 691-9404
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/11/2019
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