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WALGREEN CO.
CH0515200 Access Community Health Centers, Inc
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Covered Entity Details
Entity Name
Access Community Health Centers, Inc
Subdivision Name
Joyce & Marshall Erdman Clinic
Type
HRSA-Funded Health Center
340B ID
CH0515200
Entity Address
2202 S Park St
Madison, WI 53713-1916
Grant Number
H80CS00280
Participating Start Date
1/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04155
15 E. MAIN STREET
MADISON, WI 53703
Pharmacy Comments
Contract Details
Approval Date
7/10/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ken Loving, CEO
(608) 443-5590
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/10/2017
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