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WALGREEN CO.
CH05306AR Sixteenth Street Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Sixteenth Street Community Health Centers, Inc.
Subdivision Name
Sixteenth Street Community Health Centers- Augustine Prep Academy
Type
HRSA-Funded Health Center
340B ID
CH05306AR
Entity Address
2607 S 5th St, Ste B
Milwaukee, WI 53207-1418
Grant Number
H80CS00593
Participating Start Date
7/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05601
4730 S 27TH STREET
MILWAUKEE, WI 53221
Pharmacy Comments
Contract Details
Approval Date
7/12/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Liz Claudio, Vice President, Operations
(414) 897-5165
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2022
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