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WALGREEN ARIZONA DRUG CO.
CH061230 CENTRO DE SALUD FAMILIAR LA FE, INC.
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Covered Entity Details
Entity Name
CENTRO DE SALUD FAMILIAR LA FE, INC.
Subdivision Name
CENTRAL CLINIC
Type
HRSA-Funded Health Center
340B ID
CH061230
Entity Address
700 SOUTH OCHOA
EL PASO, TX 79901
Grant Number
H80CS00128
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
WALGREENS CENTRAL FILL #21372
120 N 83RD AVE
STE 200
TOLLESON, AZ 85353
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Salvador Balcorta, CEO
(915) 534-7979
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2023
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