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WALGREEN CO.
CH08165T Clinica Campesina Family Health Services
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Covered Entity Details
Entity Name
Clinica Campesina Family Health Services
Subdivision Name
Clinica Family Health - Nederland
Type
HRSA-Funded Health Center
340B ID
CH08165T
Entity Address
80 Big Springs Dr STE 102
Nederland, CO 80466
Grant Number
H80CS00690
Participating Start Date
10/1/2022
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05644
750 E 120TH AVE
NORTHGLENN, CO 80233
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
Simon Smith, CEO
(303) 665-3036 Ext: 1003
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/2/2024
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