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WALGREEN CO.
CH0421240 FAIRVIEW COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
FAIRVIEW COMMUNITY HEALTH CENTER
Subdivision Name
DBA FAIRVIEW COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0421240
Entity Address
225 NATCHEZ TRACE AVE
BOWLING GREEN, KY 42103-7995
Grant Number
H80CS00856
Participating Start Date
10/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04448
1145 U.S. 31 W. BYPASS
BOWLING GREEN, KY 42101
Pharmacy Comments
Contract Details
Approval Date
7/6/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Lillybridge, Executive Director
(270) 783-3573 Ext: 1032
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/6/2023
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