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WALGREEN ARIZONA DRUG CO.
STD85712 CAN Community Health, Inc.
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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
WALGREENS CENTRAL FILL #21372
120 N 83RD AVE
STE 200
TOLLESON, AZ 85353
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
7/1/2025
Covered Entity Terminated
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
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