Contract Pharmacy Details

WALGREEN CO.
CH05190B Heartland Alliance Health, Inc.

Covered Entity Details

Entity Name

Heartland Alliance Health, Inc.

Subdivision Name

HEARTLAND ALLIANCE HEALTH - ENGLEWOOD

Type

HRSA-Funded Health Center

340B ID

CH05190B

Entity Address

5501 S HALSTED ST
CHICAGO, IL 60621-2229

Grant Number

H80CS00111

Participating Start Date

7/1/2018

Last Recertification Date

1/29/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #10485
12854 S ASHLAND AVE
CALUMET PARK, IL 60827-6308

Pharmacy Comments

Contract Details

Approval Date

1/5/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Mary Kay Gilbert, Interim Executive Director
(770) 361-7293

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/5/2024

340B Drug Pricing Program Database