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WALGREEN CO.
CH05642J LAWNDALE CHRISTIAN HEALTH CENTER
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Covered Entity Details
Entity Name
LAWNDALE CHRISTIAN HEALTH CENTER
Subdivision Name
LCHC at Breakthrough Men's Shelter
Type
HRSA-Funded Health Center
340B ID
CH05642J
Entity Address
402 N Saint Louis Ave
CHICAGO, IL 60624-1332
Grant Number
H80CS00725
Participating Start Date
10/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01249
4800 W CERMAK RD
CICERO, IL 60804
Pharmacy Comments
Contract Details
Approval Date
7/2/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/6/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Christopher Robert Dons, Chief Financial Officer
(872) 588-3032
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/2/2024
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