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Walgreens #21423
CHC12888-02 LORAIN COUNTY HEALTH & DENTISTRY
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Covered Entity Details
Entity Name
LORAIN COUNTY HEALTH & DENTISTRY
Subdivision Name
Lorain County Health & Dentistry
Type
HRSA-Funded Health Center
340B ID
CHC12888-02
Entity Address
1205 Broadway Ave.
Lorain, OH 44052-3409
Grant Number
H80CS12888
Participating Start Date
7/1/2013
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
Walgreens #21423
Pharmacy Address
Walgreens Central Fill #21423
6275 Winchester Blvd
Canal WInchester, OH 43110-6537
Pharmacy Comments
Contract Details
Approval Date
10/4/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
stephanie wiersma, CEO
(440) 233-0159
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/4/2023
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