Contract Pharmacy Details

WALGREEN CO.
CHC26566-06 JANE PAULEY COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

JANE PAULEY COMMUNITY HEALTH CENTER, INC.

Subdivision Name

Jane Pauley Center at Shadeland

Type

HRSA-Funded Health Center

340B ID

CHC26566-06

Entity Address

2040 N Shadeland Ave STE 300
Indianapolis, IN 46219-1712

Grant Number

H80CS26566

Participating Start Date

4/1/2014

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 02800
8905 E 10TH ST
INDIANAPOLIS, IN 46219

Pharmacy Comments

Contract Details

Approval Date

1/9/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Dale Marion, 340B Program Manager
(317) 552-0690

Contract Pharmacy Representative

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

Signed By Date

1/9/2024

340B Drug Pricing Program Database