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WALGREEN CO.
CH0512480 CHRISTIAN COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
CHRISTIAN COMMUNITY HEALTH CENTER
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0512480
Entity Address
9718 S Halsted Street
CHICAGO, IL 60628-1007
Grant Number
H80CS00594
Participating Start Date
7/1/2006
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05825
1213 W 79TH STREET
CHICAGO, IL 60620-3706
Pharmacy Comments
Contract Details
Approval Date
4/7/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KENNETH A. BURNETT, CHIEF EXECUTIVE OFFICER
(773) 298-4745
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/7/2016
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