Contract Pharmacy Details

WALGREEN CO.
CHC12883-00 SOUTH CENTRAL MEDICAL & RESOURCE CENTER

Covered Entity Details

Entity Name

SOUTH CENTRAL MEDICAL & RESOURCE CENTER

Subdivision Name

South Central Medical and Resource Center

Type

HRSA-Funded Health Center

340B ID

CHC12883-00

Entity Address

216 S Main St
Lindsay, OK 73052-5634

Grant Number

H80CS12883

Participating Start Date

1/1/2009

Last Recertification Date

2/17/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #13123
116 N. GREEN AVENUE
PURCELL, OK 73080

Pharmacy Comments

Contract Details

Approval Date

1/11/2023

Contract Begin Date

4/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/11/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Dana Ramming, CEO
(405) 756-1414

Contract Pharmacy Representative

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

Signed By Date

1/11/2023

340B Drug Pricing Program Database