Contract Pharmacy Details

WALGREEN CO.
CH056750 NEIGHBORHOOD HEALTHSOURCE

Covered Entity Details

Entity Name

NEIGHBORHOOD HEALTHSOURCE

Subdivision Name

FREMONT CLINIC

Type

HRSA-Funded Health Center

340B ID

CH056750

Entity Address

3300 Fremont Ave N
Minneapolis, MN 55412-2405

Grant Number

H80CS00516

Participating Start Date

1/1/2003

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #13607
4100 WEST BROADWAY AVE
ROBBINSDALE, MN 55422

Pharmacy Comments

Contract Details

Approval Date

4/2/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Steven J. Knutson, Executive Director
(612) 287-2428

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/2/2013

340B Drug Pricing Program Database