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Walgreens Central Fill #21399
CH0510700 OPEN DOOR HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
OPEN DOOR HEALTH SERVICES, INC.
Subdivision Name
Open Door Health Services
Type
HRSA-Funded Health Center
340B ID
CH0510700
Entity Address
333 S Madison Street
Suite 79
Muncie, IN 47305
Grant Number
H80CS00340
Participating Start Date
4/1/2001
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
Walgreens Central Fill #21399
Pharmacy Address
4132Plainfield Rd
Ste 110
Indianapolis, IN 46231-7021
Pharmacy Comments
Contract Details
Approval Date
4/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kourtney L McCauliff, VP - HR acting CEO
(765) 286-7000
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/3/2023
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