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WALGREEN CO
STD48651 Central Michigan District Health Department
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Covered Entity Details
Entity Name
Central Michigan District Health Department
Subdivision Name
Prudenville location
Type
Sexually Transmitted Diseases
340B ID
STD48651
Entity Address
200 Grand Ave.
Suite A
Prudenville, MI 48651
Grant Number
NH25PS005170
Participating Start Date
1/1/2021
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11887
1141 N MCEWAN ST
CLARE, MI 48617-1107
Pharmacy Comments
Contract Details
Approval Date
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jaclyn Badger, Health Promotion Director
(989) 773-5921 Ext: 1628
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/11/2024
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