Contract Pharmacy Details

WALGREEN CO.
STD46226 DAMIEN CENTER INC, THE

Covered Entity Details

Entity Name

DAMIEN CENTER INC, THE

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD46226

Entity Address

8902 E 38th St.
Indianapolis, IN 46226

Grant Number

NU62PS924556

Participating Start Date

4/1/2021

Last Recertification Date

5/13/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS SPECIALTY PHARMACY #16317
335 MASSACHUSETTS AVENUE
INDIANAPOLIS, IN 46204

Pharmacy Comments

Contract Details

Approval Date

4/7/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Alan Witchey, President and CEO
(317) 632-0123 Ext: 266

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/7/2021

340B Drug Pricing Program Database