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Walgreen CO
CH05306AY Sixteenth Street Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Sixteenth Street Community Health Centers, Inc.
Subdivision Name
Sixteenth Street Community Health Centers - United Community Center-Bruce-Guadalupe Community School
Type
HRSA-Funded Health Center
340B ID
CH05306AY
Entity Address
1028 S 9th St Rm Llhc
Milwaukee, WI 53204-1335
Grant Number
H80CS00593
Participating Start Date
1/1/2022
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
Walgreen CO
Pharmacy Address
DBA Walgreens Central Fill #21417
599 S Schmidt Rd
Ste A
Bolingbrook, IL 60440-9405
Pharmacy Comments
Contract Details
Approval Date
4/9/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Liz Claudio, Vice President, Operations
(414) 897-5165
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/9/2024
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