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Walgreen Arizona Drug Co.
CHC28969-00 Amador Health Center, Inc.
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Covered Entity Details
Entity Name
Amador Health Center, Inc.
Subdivision Name
Amador Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CHC28969-00
Entity Address
999 W Amador Avenue Suite A
Las Cruces, NM 88005-2739
Grant Number
H80CS28969
Participating Start Date
1/1/2019
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
Walgreen Arizona Drug Co.
Pharmacy Address
Walgreens Central Fill #21372
120 N 83rd Ave
200
Tolleson, AZ 85353
Pharmacy Comments
Contract Details
Approval Date
4/12/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Pamela L Angell, CEO
(575) 527-5482
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/12/2022
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