Contract Pharmacy Details

WALGREEN CO.
CHC30718-00 SIGNATURE HEALTH, INC.

Covered Entity Details

Entity Name

SIGNATURE HEALTH, INC.

Subdivision Name

Signature Health, Inc. Administration

Type

HRSA-Funded Health Center

340B ID

CHC30718-00

Entity Address

7232 Justin Way
Mentor, OH 44060-7875

Grant Number

H80CS30718

Participating Start Date

4/1/2017

Last Recertification Date

2/22/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03308
4265 STATE RD.
CLEVELAND, OH 44109

Pharmacy Comments

Contract Details

Approval Date

4/15/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jonathan Albert Lee, CEO
(440) 953-9999 Ext: 705133

Contract Pharmacy Representative

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

Signed By Date

4/15/2020

340B Drug Pricing Program Database