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Walgreen Arizona Drug Co.
CH090160 EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
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Covered Entity Details
Entity Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Subdivision Name
EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH090160
Entity Address
839 WEST CONGRESS ST
TUCSON, AZ 85745
Grant Number
H80CS00230
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
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
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2022
Agreement registered in error
Contacts
Covered Entity Signing Official
Nancy Johnson, CEO
(520) 309-2011
Contract Pharmacy Representative
Walgreens
Lee Reighard, Analyst
(847) 964-7147
Signed By Date
4/15/2022
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