Contract Pharmacy Details

WALGREEN CO.
CH0537520 COVENANT COMMUNITY CARE, INC.

Covered Entity Details

Entity Name

COVENANT COMMUNITY CARE, INC.

Subdivision Name

Covenant Michigan Avenue Clinic

Type

HRSA-Funded Health Center

340B ID

CH0537520

Entity Address

5716 Michigan Ave
Detroit, MI 48210-3039

Grant Number

H80CS08738

Participating Start Date

10/1/2007

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05426
1815 ROCHESTER ROAD
ROYAL OAK, MI 48073

Pharmacy Comments

Contract Details

Approval Date

1/8/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/15/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Paul Propson, CEO
(313) 228-0216

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/8/2015

340B Drug Pricing Program Database