Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
RWI606401 UI Health Community Clinic Network

Covered Entity Details

Entity Name

UI Health Community Clinic Network

Subdivision Name

North Side (Uptown)

Type

Ryan White Part A

340B ID

RWI606401

Entity Address

845 W Wilson Ave
Chicago, IL 60640

Grant Number

H89HA00008

Participating Start Date

10/1/2019

Last Recertification Date

2/19/2025

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

4/10/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Richard M. Novak, Chief, Division of Infectious Diseases/Ryan White Part A and C Project Director
(312) 996-6763

Contract Pharmacy Representative

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

Signed By Date

4/10/2020

340B Drug Pricing Program Database