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WALGREEN CO.
CH053086A Lifecare Family Health & Dental Center, Inc.
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Covered Entity Details
Entity Name
Lifecare Family Health & Dental Center, Inc.
Subdivision Name
Lincoln Street Health Center
Type
HRSA-Funded Health Center
340B ID
CH053086A
Entity Address
2725 Lincoln St E
Canton, OH 44707-2769
Grant Number
H80CS06654
Participating Start Date
4/1/2008
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04983
4024 FULTON DR. NW
CANTON, OH 44718
Pharmacy Comments
Contract Details
Approval Date
10/7/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janet C McPeek, CEO
(234) 521-7213
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/7/2021
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