Contract Pharmacy Details

WALGREEN ARIZONA DRUG CO.
STD85712 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Tucson

Type

Sexually Transmitted Diseases

340B ID

STD85712

Entity Address

6252 E Grant Rd
Tucson, AZ 85712

Grant Number

1 NU62PS924550-01-00

Participating Start Date

10/1/2021

Last Recertification Date

5/27/2024

Entity Termination Date

7/1/2025

Pharmacy Details

Pharmacy Name

WALGREEN ARIZONA DRUG CO.

Pharmacy Address

DBA: WALGREENS # 04764
5455 E SPEEDWAY BLVD
TUCSON, AZ 85712

Pharmacy Comments

Contract Details

Approval Date

10/18/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/21/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127

Contract Pharmacy Representative

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

Signed By Date

10/18/2021

340B Drug Pricing Program Database