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WALGREEN CO.
CH0530890 NATIVE AMERICAN COMMUNITY CLINIC
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Covered Entity Details
Entity Name
NATIVE AMERICAN COMMUNITY CLINIC
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH0530890
Entity Address
1213 E. FRANKLIN AVENUE
MINNEAPOLIS, MN 55404
Grant Number
H80CS06661
Participating Start Date
7/1/2006
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
W002:WALGREENS #16361
2650 HENNEPIN AVE.
MINNEAPOLIS, MN 55408
Pharmacy Comments
Contract Details
Approval Date
1/18/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kari Rabie, Medical Director
(612) 872-8086 Ext: 1008
Contract Pharmacy Representative
Native American Community Clinic
Felicia Hernandez, Clinic Manager
(612) 872-8086
Signed By Date
1/18/2024
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