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Walgreens Central Fill #21399
CH05972E AUNT MARTHA'S HEALTH & WELLNESS, INC.
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Covered Entity Details
Entity Name
AUNT MARTHA'S HEALTH & WELLNESS, INC.
Subdivision Name
Chicago Heights Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH05972E
Entity Address
1536 Vincennes
Chicago Heights, IL 60411-3458
Grant Number
H80CS00685
Participating Start Date
7/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
Walgreens Central Fill #21399
Pharmacy Address
4132Plainfield Rd
Ste 110
Indianapolis, IN 46231-7021
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Audrey Pennington, Chief Operating Officer
(708) 747-7100
Contract Pharmacy Representative
Walgreens
Cheryl Mullins, 340B Client Relationship Analysist
(847) 527-2432
Signed By Date
1/17/2023
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