Contract Pharmacy Details

WALGREEN CO.
CHC08238-07 Change, Incorporated

Covered Entity Details

Entity Name

Change, Incorporated

Subdivision Name

FMC MAT

Type

HRSA-Funded Health Center

340B ID

CHC08238-07

Entity Address

114 Taylor Ave
Weirton, WV 26062-4629

Grant Number

H80CS08238

Participating Start Date

1/1/2019

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #19991
126 12TH ST.
WELLSBURG, WV 26070-1572

Pharmacy Comments

Contract Details

Approval Date

4/18/2023

Contract Begin Date

4/18/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lisa Mowry, CEO
(304) 797-7733 Ext: 1311

Contract Pharmacy Representative

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

Signed By Date

4/18/2023

340B Drug Pricing Program Database