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WALGREEN CO.
CH053200 HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
HealthNet Administration/HealthNet Specialty Care at Barrington
Type
HRSA-Funded Health Center
340B ID
CH053200
Entity Address
3403 E Raymond St
Indianapolis, IN 46203
Grant Number
H80CS00114
Participating Start Date
12/1/1992
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #21257
902 E HANNA AVE
INDIANAPOLIS, IN 46227
Pharmacy Comments
Contract Details
Approval Date
3/22/2011
Contract Begin Date
4/1/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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