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WALGREEN CO.
CH04327AZ EAU CLAIRE COOPERATIVE HEALTH CENTER
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Covered Entity Details
Entity Name
EAU CLAIRE COOPERATIVE HEALTH CENTER
Subdivision Name
Waverly Women's Health
Type
HRSA-Funded Health Center
340B ID
CH04327AZ
Entity Address
2117 Gervais St
Columbia, SC 29204-1805
Grant Number
H80CS00730
Participating Start Date
4/1/2023
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11433
1941 BLOSSOM ST.
COLUMBIA, SC 29205
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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