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WALGREEN CO.
CH051827A ASIAN HUMAN SERVICES FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
ASIAN HUMAN SERVICES FAMILY HEALTH CENTER
Subdivision Name
AHS Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH051827A
Entity Address
6301 N. Western Ave.
Chicago, IL 60659-2009
Grant Number
H80CS02327
Participating Start Date
4/1/2004
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #13924
1775 W DEMPSTER ST STE T01116
PARK RIDGE, IL 60068
Pharmacy Comments
Contract Details
Approval Date
10/26/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Muhammad W. Paracha, CEO
(773) 761-0300 Ext: 2409
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/26/2015
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