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WALGREEN CO.
CH056750 NEIGHBORHOOD HEALTHSOURCE
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTHSOURCE
Subdivision Name
FREMONT CLINIC
Type
HRSA-Funded Health Center
340B ID
CH056750
Entity Address
3300 Fremont Ave N
Minneapolis, MN 55412-2405
Grant Number
H80CS00516
Participating Start Date
1/1/2003
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06714
2860 COON RAPIDS BLVD NW
COON RAPIDS, MN 55433
Pharmacy Comments
Contract Details
Approval Date
7/6/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steven J. Knutson, Executive Director
(612) 287-2428
Contract Pharmacy Representative
Walgreens
Aliena Jaffri, 340b Client Relationship Analyst
(847) 964-6103
Signed By Date
7/6/2020
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