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WALGREEN CO.
CH053210 ERIE FAMILY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
ERIE FAMILY HEALTH CENTER, INC.
Subdivision Name
ERIE WEST TOWN HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH053210
Entity Address
1701 W Superior St
Chicago, IL 60622
Grant Number
H80CS00115
Participating Start Date
1/1/1997
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15004
953 W. IRVING PARK RD.
CHICAGO, IL 60613
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Bruce, Chief Financial & Administrative Officer (CFAO)
(312) 432-2725
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/14/2019
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