Contract Pharmacy Details

WALGREEN CO.
RWI60120 OPEN DOOR CLINIC OF GREATER ELGIN

Covered Entity Details

Entity Name

OPEN DOOR CLINIC OF GREATER ELGIN

Subdivision Name

Type

Ryan White Part A

340B ID

RWI60120

Entity Address

1665 Larkin Ave
ELGIN, IL 60123

Grant Number

H89HA00008

Participating Start Date

4/1/2012

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 07100
1700 LARKIN AVE
ELGIN, IL 60123-5947

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

zeba s geloo, medical director
(847) 695-1093

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