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Walgreens #21435
CH100160 COMMUNITY HEALTH CLINICS, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CLINICS, INC.
Subdivision Name
TERRY REILLY HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH100160
Entity Address
211 16th Ave N
Nampa, ID 83687-4058
Grant Number
H80CS00636
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
Walgreens #21435
Pharmacy Address
Walgreens Central Fill #21435
6306 S Airport Rd
West Jordan, UT 84084-5601
Pharmacy Comments
Contract Details
Approval Date
10/17/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Heidi Hart, CEO
(208) 318-1255
Contract Pharmacy Representative
WALGREENS CO
KARL MEEHAN, VICE PRESIDENT,HEALTH SYSTEMS PROGRAMS
(847) 315-2663
Signed By Date
10/17/2023
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