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WALGREEN CO.
CH07030AB NORTHEAST MISSOURI HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
NORTHEAST MISSOURI HEALTH COUNCIL, INC.
Subdivision Name
Northeast Missouri Mobile Services
Type
HRSA-Funded Health Center
340B ID
CH07030AB
Entity Address
1506 Crown Dr
Kirksville, MO 63501
Grant Number
H80CS00731
Participating Start Date
1/1/2021
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09986
311 N BALTIMORE ST
KIRKSVILLE, MO 63501-3209
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
ANDREW GRIMM, EXECUTIVE DIRECTOR
(660) 627-5757
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2023
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