Contract Pharmacy Details

WALGREEN CO.
RWI60120 OPEN DOOR CLINIC OF GREATER ELGIN

Covered Entity Details

Entity Name

OPEN DOOR CLINIC OF GREATER ELGIN

Subdivision Name

Type

Ryan White Part A

340B ID

RWI60120

Entity Address

1665 Larkin Ave
ELGIN, IL 60123

Grant Number

H89HA00008

Participating Start Date

4/1/2012

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 01131
1051 OAK STREET
NORTH AURORA, IL 60542

Pharmacy Comments

Contract Details

Approval Date

12/15/2022

Contract Begin Date

12/20/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Perry Maier, Executive Director
(847) 695-1093

Contract Pharmacy Representative

Open Door Healh Centers of Illonis
Perry Maier, Executive Director
(847) 695-1093

Signed By Date

12/15/2022

340B Drug Pricing Program Database