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WALGREEN CO.
CH051920 OUTREACH COMMUNITY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
OUTREACH COMMUNITY HEALTH CENTERS, INC.
Subdivision Name
Outreach Community Health Centers, Incorporated
Type
HRSA-Funded Health Center
340B ID
CH051920
Entity Address
220 W Capitol Drive
Milwaukee, WI 53212-1123
Grant Number
H80CS00034
Participating Start Date
1/1/2008
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #21254
2265 N MAYFAIR RD.
WAUWATOSA, WI 53226
Pharmacy Comments
Contract Details
Approval Date
4/20/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Julia Harris Robinson, CFO
(414) 964-9016
Contract Pharmacy Representative
Outreach Community Health Center
Julia Harris Robinson, CFO
(414) 964-9016
Signed By Date
4/20/2023
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