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Walgreens #21423
CH03044AD Primary Care Health Services Inc
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Covered Entity Details
Entity Name
Primary Care Health Services Inc
Subdivision Name
PRIMARY CARE HEALTH SERVICES, INC. Alma Illery Medical Center
Type
HRSA-Funded Health Center
340B ID
CH03044AD
Entity Address
7227 Hamilton Ave
Pittsburgh, PA 15208
Grant Number
H80CS00714
Participating Start Date
1/2/2020
Last Recertification Date
2/14/2025
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
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
jerome gloster, CEO
(412) 244-4700 Ext: 4980
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2023
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