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WALGREEN CO.
CH07043D Big Springs Medical Association, Inc
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Covered Entity Details
Entity Name
Big Springs Medical Association, Inc
Subdivision Name
Missouri Highlands Health Care - Annapolis
Type
HRSA-Funded Health Center
340B ID
CH07043D
Entity Address
202 N Allen St
Annapolis, MO 63620-8778
Grant Number
H80CS00703
Participating Start Date
1/1/2004
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #15820
605 N MAIN STREET
IRONTON, MO 63650
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
Karen R White, CEO
(573) 663-2313 Ext: 3965
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2023
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