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WALGREENS MAIL SERVICE, INC.
CH032240 PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)
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Covered Entity Details
Entity Name
PENINSULA INSTITUTE FOR COMMUNITY HEALTH (PICH)
Subdivision Name
DBA 48TH STREET PHYSICIANS
Type
HRSA-Funded Health Center
340B ID
CH032240
Entity Address
4714 MARSHALL AVENUE
NEWPORT NEWS, VA 23607-2247
Grant Number
H80CS00073
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, INC.
Pharmacy Address
8350 S RIVER PARKWAY
TEMPE, AZ 85284
Pharmacy Comments
Contract Details
Approval Date
10/29/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/11/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ANGELA FUTRELL, CEO
(757) 591-0643 Ext: 1120
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/29/2013
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