Contract Pharmacy Details

WALGREEN CO.
CH0512780 Tapestry 360 Health

Covered Entity Details

Entity Name

Tapestry 360 Health

Subdivision Name

Tapestry 360 Health - Administration

Type

HRSA-Funded Health Center

340B ID

CH0512780

Entity Address

1301 W Devon Ave
Chicago, IL 60660

Grant Number

H80CS00215

Participating Start Date

1/1/2004

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #15004
953 W. IRVING PARK RD.
CHICAGO, IL 60613

Pharmacy Comments

Contract Details

Approval Date

1/14/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gwenn Rausch, CEO
(773) 296-7587

Contract Pharmacy Representative

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

Signed By Date

1/14/2017

340B Drug Pricing Program Database