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WALGREEN CO
STD48624 Central Michigan District Health Department
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Covered Entity Details
Entity Name
Central Michigan District Health Department
Subdivision Name
Gladwin location
Type
Sexually Transmitted Diseases
340B ID
STD48624
Entity Address
103 N. Bowery Avenue
Gladwin, MI 48624
Grant Number
NH25PS005170
Participating Start Date
1/1/2021
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #12534
1301 N US HWY 31
PETOSKEY, MI 49770
Pharmacy Comments
Contract Details
Approval Date
1/6/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jaclyn Badger, Health Promotion Director
(989) 773-5921 Ext: 1628
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/6/2025
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