Contract Pharmacy Details

WALGREEN CO.
CH108170 Dirne Health Centers, Inc.

Covered Entity Details

Entity Name

Dirne Health Centers, Inc.

Subdivision Name

Heritage Health CDA

Type

HRSA-Funded Health Center

340B ID

CH108170

Entity Address

1090 W Park Pl
Coeur D Alene, ID 83814-2785

Grant Number

H80CS02331

Participating Start Date

4/1/2004

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #10314
260 W HONEYSUCKLE AVE
HAYDEN, ID 83835-9270

Pharmacy Comments

Contract Details

Approval Date

2/14/2012

Contract Begin Date

2/14/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Michael Baker, CEO
(208) 292-0256

Contract Pharmacy Representative

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

Signed By Date

2/23/2012

340B Drug Pricing Program Database