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WALGREEN CO
CHC26601-00 Full Circle Health, Inc.
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Covered Entity Details
Entity Name
Full Circle Health, Inc.
Subdivision Name
Full Circle Health - Meridian
Type
HRSA-Funded Health Center
340B ID
CHC26601-00
Entity Address
2275 S Eagle Rd STE 120
Meridian, ID 83642-2620
Grant Number
H80CS26601
Participating Start Date
4/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11452
3263 N EAGLE RD
MERIDIAN, ID 83646
Pharmacy Comments
Contract Details
Approval Date
4/2/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tad Arnt, Chief Operating Officer
(208) 514-2500 Ext: 1104
Contract Pharmacy Representative
Family Medicine Residency of Idaho
Jared L Moore, Director of Pharmacy
(208) 514-2500 Ext: 7040
Signed By Date
4/2/2024
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