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WALGREEN ARIZONA DRUG CO.
RWII86305B Northland Cares
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Covered Entity Details
Entity Name
Northland Cares
Subdivision Name
Cottonwood
Type
Ryan White Part B
340B ID
RWII86305B
Entity Address
203 S. Candy Lane, Suite 3AB
Cottonwood, AZ 86326
Grant Number
X07HA00080
Participating Start Date
1/1/2017
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
DBA: WALGREENS # 04065
1995 W HIGHWAY 89A
SEDONA, AZ 86336
Pharmacy Comments
Contract Details
Approval Date
4/2/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vonda Ann Chisholm, Executive Director
(928) 776-4612 Ext: 104
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/2/2021
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