Contract Pharmacy Details

WALGREEN CO.
CHC25683-00 CINCINNATI, CITY OF

Covered Entity Details

Entity Name

CINCINNATI, CITY OF

Subdivision Name

Elm Street Health Center

Type

HRSA-Funded Health Center

340B ID

CHC25683-00

Entity Address

1525 Elm Street
Cincinnati, OH 45202-6957

Grant Number

H80CS25683

Participating Start Date

4/1/2013

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06653
3105 GLENDALE MILFORD ROAD
CINCINNATI, OH 45241-3134

Pharmacy Comments

Contract Details

Approval Date

4/4/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Domonic Hopson, ceo ccpc
(513) 357-7361

Contract Pharmacy Representative

City of Cincinnati Health Department
David W Miller, Director of Pharmacy
(513) 357-7357

Signed By Date

4/4/2022

340B Drug Pricing Program Database