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WALGREENS SPECIALTY PHARMACY, LLC
CH051900 Heartland Alliance Health
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Covered Entity Details
Entity Name
Heartland Alliance Health
Subdivision Name
Heartland Alliance Health - Uptown
Type
HRSA-Funded Health Center
340B ID
CH051900
Entity Address
4009 N Broadway St
Chicago, IL 60613-2110
Grant Number
H80CS00111
Participating Start Date
1/1/2001
Last Recertification Date
1/29/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
4/6/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ed Stellon, Executive Director
(773) 751-4109
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/6/2020
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