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WALGREENS SPECIALTY PHARMACY, LLC
CH05198AE Alcona Citizens For Health, Inc.
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Covered Entity Details
Entity Name
Alcona Citizens For Health, Inc.
Subdivision Name
Dr. Rudy Barba Psychiatry Services
Type
HRSA-Funded Health Center
340B ID
CH05198AE
Entity Address
101 S. Union Street Unit 101 RM 1
Plymouth, MI 48170
Grant Number
H80CS00679
Participating Start Date
4/1/2018
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
7/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nancy Spencer, CEO
(989) 358-3916
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2024
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