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WALGREEN CO.
CH052030 CHERRY STREET SERVICES, INC.
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Covered Entity Details
Entity Name
CHERRY STREET SERVICES, INC.
Subdivision Name
CHERRY STREET HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH052030
Entity Address
550 Cherry St SE
Grand Rapids, MI 49503-4748
Grant Number
H80CS00770
Participating Start Date
7/1/2002
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04299
2829 DIVISION AVE S.
WYOMING, MI 49548
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/9/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Tasha Blackmon, CEO
(616) 965-8215
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2019
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