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WALGREEN ARIZONA DRUG CO.
CHC12845-00 NATIVE HEALTH
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Covered Entity Details
Entity Name
NATIVE HEALTH
Subdivision Name
NATIVE HEALTH West 8800
Type
HRSA-Funded Health Center
340B ID
CHC12845-00
Entity Address
8800 N 22nd Ave
Phoenix, AZ 85021
Grant Number
H80CS12845
Participating Start Date
4/1/2012
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
DBA: WALGREENS # 03464
3402 N CENTRAL AVE
PHOENIX, AZ 85012
Pharmacy Comments
Contract Details
Approval Date
1/29/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Walter Murillo, Chief Executive Officer
(602) 279-5262
Contract Pharmacy Representative
walgreen co.
Patrick Andrews, Representative
(847) 964-8710
Signed By Date
1/29/2020
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