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WALGREEN CO.
CH06723C HIDALGO MEDICAL SERVICES, INC
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Covered Entity Details
Entity Name
HIDALGO MEDICAL SERVICES, INC
Subdivision Name
HMS COBRE HEALTH CLINIC
Type
HRSA-Funded Health Center
340B ID
CH06723C
Entity Address
1107 TOM FOY HWY
BAYARD, NM 88023-0000
Grant Number
H80CS00744
Participating Start Date
1/1/2007
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #10808
100 ROSEDALE RD.
SILVER CITY, NM 88061-8742
Pharmacy Comments
Contract Details
Approval Date
7/1/2010
Contract Begin Date
7/1/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
5/5/2010
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