Contract Pharmacy Details

WALGREEN CO.
CH071410 PEOPLES COMMUNITY HEALTH CLINIC, INC.

Covered Entity Details

Entity Name

PEOPLES COMMUNITY HEALTH CLINIC, INC.

Subdivision Name

PEOPLES COMMUNITY HEALTH CLINIC

Type

HRSA-Funded Health Center

340B ID

CH071410

Entity Address

905 Franklin St
Waterloo, IA 50703-4407

Grant Number

H80CS00815

Participating Start Date

12/1/1992

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 07455
111 W RIDGEWAY AVE
WATERLOO, IA 50701-4233

Pharmacy Comments

Contract Details

Approval Date

7/2/2014

Contract Begin Date

10/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JENNIFER LIGHTBODY, CEO
(319) 272-4311

Contract Pharmacy Representative

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

Signed By Date

7/2/2014

340B Drug Pricing Program Database