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WALGREEN CO
CH08073AN Metro Community Provider Network, Inc.
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Covered Entity Details
Entity Name
Metro Community Provider Network, Inc.
Subdivision Name
STRIDE CHC - Mobile Health Unit #2
Type
HRSA-Funded Health Center
340B ID
CH08073AN
Entity Address
7495 W 29th Ave
Wheat Ridge, CO 80033-8002
Grant Number
H80CS00217
Participating Start Date
10/1/2022
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10739
15310 E COLFAX AVE
AURORA, CO 80011
Pharmacy Comments
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Santos vera, President/CEO
(949) 572-0958
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/10/2025
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