Contract Pharmacy Details

WALGREEN ARIZONA DRUG CO.
CHC28956-00 Valle Del Sol, Inc.

Covered Entity Details

Entity Name

Valle Del Sol, Inc.

Subdivision Name

Valle del Sol_3807

Type

HRSA-Funded Health Center

340B ID

CHC28956-00

Entity Address

3807 N 7th St
Phoenix, AZ 85014-5005

Grant Number

H80CS28956

Participating Start Date

1/1/2022

Last Recertification Date

2/17/2025

Pharmacy Details

Pharmacy Name

WALGREEN ARIZONA DRUG CO.

Pharmacy Address

DBA: WALGREENS # 05222
9040 W. PEORIA AVE.
PEORIA, AZ 85345

Pharmacy Comments

Contract Details

Approval Date

4/17/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Theresa Leon, Ms
(602) 376-0507

Contract Pharmacy Representative

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

Signed By Date

4/17/2023

340B Drug Pricing Program Database