Contract Pharmacy Details

WALGREEN CO.
CH06723F HIDALGO MEDICAL SERVICES, INC

Covered Entity Details

Entity Name

HIDALGO MEDICAL SERVICES, INC

Subdivision Name

HMS-BAYARD COMMUNITY HEALTH CTR

Type

HRSA-Funded Health Center

340B ID

CH06723F

Entity Address

805 TOM FOY BLVD
BAYARD, NM 88023-9767

Grant Number

H80CS00744

Participating Start Date

1/1/2007

Last Recertification Date

2/9/2018

Entity Termination Date

4/1/2019

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

Contract Termination Date
Termination Reason

4/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

5/5/2010

340B Drug Pricing Program Database