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WALGREEN CO
CH056420 LAWNDALE CHRISTIAN HEALTH CENTER
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Covered Entity Details
Entity Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
Lawndale Christian Health Center Main Clinic
Type
HRSA-Funded Health Center
340B ID
CH056420
Entity Address
3860 W Ogden Ave
Chicago, IL 60623-2460
Grant Number
H80CS00725
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA WALGREENS
4400 STATE RD 19
WINDSOR, WI 53598
Pharmacy Comments
Contract Details
Approval Date
2/2/2012
Contract Begin Date
2/2/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/9/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
BRUCE MILLER, CEO
(872) 588-3012
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
2/2/2012
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