Contract Pharmacy Details

WALGREEN CO.
CH051750 ACCESS COMMUNITY HEALTH NETWORK

Covered Entity Details

Entity Name

ACCESS COMMUNITY HEALTH NETWORK

Subdivision Name

ADMINISTRATIVE OFFICES

Type

HRSA-Funded Health Center

340B ID

CH051750

Entity Address

600 W Fulton
STE 300
CHICAGO, IL 60661

Grant Number

H80CS00834

Participating Start Date

7/1/2004

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 00232
3405 S KING DR
CHICAGO, IL 60616

Pharmacy Comments

9/27/10 UPDATED PHARMACY NAME (WAS WALGREENS #245);

Contract Details

Approval Date

9/28/2010

Contract Begin Date

10/1/2010

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/26/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

DONNA THOMPSON, CEO
(312) 526-2051

Contract Pharmacy Representative

KERMIT R. CRAWFORD, EXECUTIVE VICE PRESIDENT OF PHARMACY
(847) 315-3154

Signed By Date

8/23/2010

340B Drug Pricing Program Database