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WALGREENS SPECIALTY PHARMACY, LLC
CH091963G LIVINGSTON COMMUNITY HEALTH
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Covered Entity Details
Entity Name
LIVINGSTON COMMUNITY HEALTH
Subdivision Name
Livingston Community Health Campus, B Street, Buildings A, B, C
Type
HRSA-Funded Health Center
340B ID
CH091963G
Entity Address
600 B Street BLDG A, B, C
Livingston, CA 95334-9593
Grant Number
H80CS02588
Participating Start Date
7/1/2019
Last Recertification Date
3/3/2025
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
Leslie Abasta-Cummings, CEO
(209) 850-3545
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/12/2024
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