Contract Pharmacy Details

WALGREEN CO.
RWI60505 OPEN DOOR CLINIC OF GREATER ELGIN

Covered Entity Details

Entity Name

OPEN DOOR CLINIC OF GREATER ELGIN

Subdivision Name

AURORA CLINIC

Type

Ryan White Part A

340B ID

RWI60505

Entity Address

157 S. LINCOLN AVENUE
Suite K
AURORA, IL 60505

Grant Number

H89HA00008

Participating Start Date

4/1/2012

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS SPECIALTY PHARMACY #21184
5503 E STATE ST
ROCKFORD, IL 61108

Pharmacy Comments

Contract Details

Approval Date

12/16/2022

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

WALGREENS CO
KARL MEEHAN, VICE PRESIDENT,HEALTH SYSTEMS PROGRAMS
(847) 315-2663

Signed By Date

12/16/2022

340B Drug Pricing Program Database