Contract Pharmacy Details

WALGREEN ARIZONA DRUG CO.
STD86326 Northland Cares

Covered Entity Details

Entity Name

Northland Cares

Subdivision Name

Cottonwood

Type

Sexually Transmitted Diseases

340B ID

STD86326

Entity Address

203 S. Candy Lane, Suite 3AB
Cottonwood, AZ 86326

Grant Number

NU62PS924818

Participating Start Date

4/1/2021

Last Recertification Date

5/9/2025

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

340B Drug Pricing Program Database