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WALGREEN CO.
CH05744C PCC COMMUNITY WELLNESS CENTER
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Covered Entity Details
Entity Name
PCC COMMUNITY WELLNESS CENTER
Subdivision Name
PCC CLINIC AT THE BOULEVARD
Type
HRSA-Funded Health Center
340B ID
CH05744C
Entity Address
3456 W Franklin Blvd
Chicago, IL 60624-1308
Grant Number
H80CS00276
Participating Start Date
9/2/2008
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09470
4817 W FULLERTON AVE
CHICAGO, IL 60639-2503
Pharmacy Comments
Contract Details
Approval Date
7/10/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Urso, President & CEO
(708) 524-7686
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/10/2024
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