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WALGREEN ARIZONA DRUG CO.
CH09287R CHIRICAHUA COMMUNITY HEALTH CENTERS INC
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Covered Entity Details
Entity Name
CHIRICAHUA COMMUNITY HEALTH CENTERS INC
Subdivision Name
CCHCI Mobile Dental Unit
Type
HRSA-Funded Health Center
340B ID
CH09287R
Entity Address
1100 F Ave
Douglas, AZ 85607-1919
Grant Number
H80CS00696
Participating Start Date
4/1/2022
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
DBA: WALGREENS # 05027
1950 E FRY BLVD
SIERRA VISTA, AZ 85635
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Melk, CEO
(520) 227-9167
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2023
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