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WALGREEN CO.
STD48651 Central Michigan District Health Department
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Covered Entity Details
Entity Name
Central Michigan District Health Department
Subdivision Name
Prudenville location
Type
Sexually Transmitted Diseases
340B ID
STD48651
Entity Address
200 Grand Ave.
Suite A
Prudenville, MI 48651
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 # 07660
1220 N MITCHELL
CADILLAC, MI 49601-1261
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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