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Walgreens Central Fill #21399
CH05972I AUNT MARTHA'S HEALTH & WELLNESS, INC.
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Covered Entity Details
Entity Name
AUNT MARTHA'S HEALTH & WELLNESS, INC.
Subdivision Name
Women's Health Clinic
Type
HRSA-Funded Health Center
340B ID
CH05972I
Entity Address
233 W JOE ORR ROAD BLDG S
CHICAGO HEIGHTS, IL 60411-1744
Grant Number
H80CS00685
Participating Start Date
7/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
Walgreens Central Fill #21399
Pharmacy Address
4132Plainfield Rd
Ste 110
Indianapolis, IN 46231-7021
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Audrey Pennington, Chief Operating Officer
(708) 747-7100
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/17/2023
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