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WALGREEN CO.
CH042440 FAMILY HEALTH CARE CLINIC, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CARE CLINIC, INC.
Subdivision Name
FAMILY HEALTH CARE CLINIC, INC.--PEARL
Type
HRSA-Funded Health Center
340B ID
CH042440
Entity Address
4635 Highway 80 E
Pearl, MS 39208-4226
Grant Number
H80CS00487
Participating Start Date
7/1/2007
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12536
219 WOODLAND DRIVE NORTH
FOREST, MS 39074
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARGARET A. GRAY, PRESIDENT & CEO
(601) 825-7280 Ext: 5005
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2021
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