Contract Pharmacy Details

WALGREEN CO.
CHC26566-23 Jane Pauley Community Health Center, Inc.

Covered Entity Details

Entity Name

Jane Pauley Community Health Center, Inc.

Subdivision Name

Jane Pauley Community Health Center at Castleton

Type

HRSA-Funded Health Center

340B ID

CHC26566-23

Entity Address

7481 N. Shadeland Avenue, Suite A
Indianapolis, IN 46250-2077

Grant Number

H80CS26566

Participating Start Date

7/1/2019

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03442
7506 N SHADELAND AVE
INDIANAPOLIS, IN 46250

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