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WALGREENS SPECIALTY PHARMACY, LLC
RRC230141-00 MCLAREN FLINT
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Covered Entity Details
Entity Name
MCLAREN FLINT
Subdivision Name
Type
Rural Referral Center
340B ID
RRC230141-00
Entity Address
401 S. BALLENGER
FLINT, MI 48532
Medicare Provider Number
230141
Participating Start Date
12/22/2020
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
11/4/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/12/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
FRED KORTE, CFO
(248) 338-5691
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2021
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