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WALGREEN CO.
CH05306BA 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 - United Community Center-Bruce-Guadalupe Middle School
Type
HRSA-Funded Health Center
340B ID
CH05306BA
Entity Address
920 S 9th St Rm 140
Milwaukee, WI 53204-1361
Grant Number
H80CS00593
Participating Start Date
1/1/2022
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07730
2700 N GRANDVIEW BLVD
WAUKESHA, WI 53188-1611
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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