Contract Pharmacy Details

WALGREEN CO.
CHC26510-00 Southwest Colorado Mental Health Center, Inc.

Covered Entity Details

Entity Name

Southwest Colorado Mental Health Center, Inc.

Subdivision Name

Cortez Integrated Healthcare

Type

HRSA-Funded Health Center

340B ID

CHC26510-00

Entity Address

691 E EMPIRE ST
CORTEZ, CO 81321-2802

Grant Number

H80CS26510

Participating Start Date

4/1/2020

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #19273
28 TOWN PLAZA
DURANGO, CO 81301

Pharmacy Comments

Contract Details

Approval Date

7/16/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/31/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Pamela Wise Romero, COO
(970) 335-2202

Contract Pharmacy Representative

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

Signed By Date

7/16/2020

340B Drug Pricing Program Database