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WALGREEN CO.
CHC10591-09 COMMUNITY CLINIC, INC., THE
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Covered Entity Details
Entity Name
COMMUNITY CLINIC, INC., THE
Subdivision Name
CCI-Greenway
Type
HRSA-Funded Health Center
340B ID
CHC10591-09
Entity Address
7474 Greenway Center Drive
STE 300
Greenbelt, MD 20770
Grant Number
H80CS10591
Participating Start Date
1/1/2014
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11500
15990 ANNAPOLIS RD.
BOWIE, MD 20715
Pharmacy Comments
Contract Details
Approval Date
10/1/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sonya J. Bruton, CEO and President
(240) 839-5107
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/1/2020
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