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WALGREEN CO.
CH0512780 Tapestry 360 Health
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Covered Entity Details
Entity Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - Administration
Type
HRSA-Funded Health Center
340B ID
CH0512780
Entity Address
1301 W Devon Ave
Chicago, IL 60660
Grant Number
H80CS00215
Participating Start Date
1/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01173
1520 W FULLERTON
CHICAGO, IL 60614
Pharmacy Comments
Contract Details
Approval Date
10/3/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nicole Willis, CEO
(773) 296-7589
Contract Pharmacy Representative
Walgreens Co
Eliza Pavel, Client Relationship
(847) 315-7763
Signed By Date
10/3/2023
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