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WALGREEN CO.
CH08165AC CLINICA CAMPESINA/FAMILY HEALTH SERVICES
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Covered Entity Details
Entity Name
CLINICA CAMPESINA/FAMILY HEALTH SERVICES
Subdivision Name
Clinica Family Health & Wellness -- Norton Center for Behavioral Medicine
Type
HRSA-Funded Health Center
340B ID
CH08165AC
Entity Address
975 North St
Boulder, CO 80304-3279
Grant Number
H80CS00690
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09570
570 US HIGHWAY 287
BROOMFIELD, CO 80020-1732
Pharmacy Comments
Contract Details
Approval Date
1/29/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Simon Smith, CEO
(303) 665-3036 Ext: 1003
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/14/2025
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