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WALGREEN CO
CH04327I EAU CLAIRE COOPERATIVE HEALTH CENTER
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Covered Entity Details
Entity Name
EAU CLAIRE COOPERATIVE HEALTH CENTER
Subdivision Name
BROOKLAND COMMUNITY PEDIATRICS
Type
HRSA-Funded Health Center
340B ID
CH04327I
Entity Address
500 N 12th St
West Columbia, SC 29169-6502
Grant Number
H80CS00730
Participating Start Date
4/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10230
1537 CHARLESTON HIGHWAY
WEST COLUMBIA, SC 29169-5047
Pharmacy Comments
Contract Details
Approval Date
10/7/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PEATRA CRUZ, CHIEF ORGANIZATIONAL DEVELOPMENT OFFICER
(803) 733-5969
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/7/2024
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