Contract Pharmacy Details

WALGREEN CO.
CHC24103-00 Esperanza Health Centers

Covered Entity Details

Entity Name

Esperanza Health Centers

Subdivision Name

Esperanza California

Type

HRSA-Funded Health Center

340B ID

CHC24103-00

Entity Address

2001 S California Ave STE 100
Chicago, IL 60608-2486

Grant Number

H80CS24103

Participating Start Date

4/1/2013

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #15507
3800 W MADISON STREET SUITE 101
CHICAGO, IL 60624

Pharmacy Comments

Contract Details

Approval Date

7/8/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Dan Fulwiler, CEO
(773) 584-6200

Contract Pharmacy Representative

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

Signed By Date

7/8/2021

340B Drug Pricing Program Database