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WALGREEN CO.
CH05203P CHERRY STREET SERVICES, INC.
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Covered Entity Details
Entity Name
CHERRY STREET SERVICES, INC.
Subdivision Name
Southside Health Center
Type
HRSA-Funded Health Center
340B ID
CH05203P
Entity Address
2303 Kalamazoo Ave SE
Grand Rapids, MI 49507-3780
Grant Number
H80CS00770
Participating Start Date
4/1/2013
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 15007
425 FULLER AVE NE
GRAND RAPIDS, MI 49503
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
Tasha Blackmon, CEO
(616) 965-8215
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2023
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