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WALGREEN CO.
RWII802201B Colorado Health Network, Inc.
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Covered Entity Details
Entity Name
Colorado Health Network, Inc.
Subdivision Name
Northern Region
Type
Ryan White Part B
340B ID
RWII802201B
Entity Address
400 Remington St., Ste. 100
Fort Collins, CO 80524
Grant Number
X07HA00056
Participating Start Date
7/1/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16531
15 N UNION BLVD UNIT 120
COLORADO SPRINGS, CO 80909
Pharmacy Comments
Contract Details
Approval Date
10/12/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Darrell J Vigil, Chief Executive Officer
(303) 837-0166
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2020
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