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WALGREEN CO.
CHC28961-07 Shawnee Christian Healthcare Center, Inc.
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Covered Entity Details
Entity Name
Shawnee Christian Healthcare Center, Inc.
Subdivision Name
The Wellness Center @ Hazelwood Elementary
Type
HRSA-Funded Health Center
340B ID
CHC28961-07
Entity Address
1325 Bluegrass Ave
Louisville, KY 40215-1201
Grant Number
H80CS28961
Participating Start Date
4/1/2020
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09005
200 E BROADWAY
LOUISVILLE, KY 40202-2008
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/17/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Susan Maguire, CFO
(502) 778-0001
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2020
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