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WALGREEN CO.
CH05175L ACCESS COMMUNITY HEALTH NETWORK
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Covered Entity Details
Entity Name
ACCESS COMMUNITY HEALTH NETWORK
Subdivision Name
ACCESS Kedzie Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH05175L
Entity Address
3229-3243 W 47TH Place
Chicago, IL 60632-3011
Grant Number
H80CS00834
Participating Start Date
7/1/2003
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05926
4385 S ARCHER AVE
CHICAGO, IL 60632
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mahomed Ouedraogo, Chief Executive Officer
(312) 526-2360
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2024
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