340B Drug Pricing Program Database
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WALGREEN CO.
CH05320D HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
Martindale-Brightwood Health Center
Type
HRSA-Funded Health Center
340B ID
CH05320D
Entity Address
2855 N Keystone Ave Ste 100
Ste 100
Indianapolis, IN 46218-2790
Grant Number
H80CS00114
Participating Start Date
10/1/1996
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 11248
3545 W 86TH STREET
INDIANAPOLIS, IN 46268
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Varon Edward Cantrell, Chief Medical Officer
(317) 957-2015
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2023
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