Contract Pharmacy Details

WALGREEN CO.
CH052090 MILWAUKEE HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

MILWAUKEE HEALTH SERVICES, INC.

Subdivision Name

MILWAUKEE HEALTH SERVICES, INC.

Type

HRSA-Funded Health Center

340B ID

CH052090

Entity Address

2555 N Dr Martin Luther King Dr
Milwaukee, WI 53212-2709

Grant Number

H80CS00826

Participating Start Date

12/1/1992

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04720
2222 W. CAPITOL
MILWAUKEE, WI 53206

Pharmacy Comments

Contract Details

Approval Date

10/8/2013

Contract Begin Date

1/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/15/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Tito Izard, President/CEO
(414) 267-2021

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/8/2013

340B Drug Pricing Program Database