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WALGREEN CO
CH077470 RURAL ALLIANCE FOR BETTER FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
RURAL ALLIANCE FOR BETTER FAMILY HEALTH, THE
Subdivision Name
Southern Missouri Community Health Center West Plains Clinic
Type
HRSA-Funded Health Center
340B ID
CH077470
Entity Address
1137 Independence Dr
West Plains, MO 65775-4221
Grant Number
H80CS00301
Participating Start Date
10/1/2003
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11288
1010 WORLEY DRIVE
WEST PLAINS, MO 65775
Pharmacy Comments
Contract Details
Approval Date
7/16/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/11/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
PAT RICHARDS, CEO
(417) 255-8464
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/16/2014
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