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WALGREEN CO.
CH051900 Heartland Alliance Health
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Covered Entity Details
Entity Name
Heartland Alliance Health
Subdivision Name
Heartland Alliance Health - Uptown
Type
HRSA-Funded Health Center
340B ID
CH051900
Entity Address
4009 N Broadway St
Chicago, IL 60613-2110
Grant Number
H80CS00111
Participating Start Date
1/1/2001
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
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