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WALGREEN CO.
CH05306AX 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 - Cristo Rey High School
Type
HRSA-Funded Health Center
340B ID
CH05306AX
Entity Address
1818 W National Ave RM 100 HLTH
Milwaukee, WI 53204-1118
Grant Number
H80CS00593
Participating Start Date
1/27/2021
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03883
221 E SUNSET DR
WAUKESHA, WI 53189
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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