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WALGREEN CO.
CH046840 FAMILY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS, INC.
Subdivision Name
FAMILY HEALTH CENTERS, INC./FAMILY HEALTH CENTER - PORTLAND
Type
HRSA-Funded Health Center
340B ID
CH046840
Entity Address
2215 Portland Ave
Attn:Pharmacy
Louisville, KY 40212-1033
Grant Number
H80CS00102
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 15183
3410 W BROADWAY ST
LOUISVILLE, KY 40211
Pharmacy Comments
01/07/2013 pharmacy update, relocation(was WALGREENS # 02538 3421 W BROADWAY ST)
Contract Details
Approval Date
1/12/2011
Contract Begin Date
1/12/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
12/15/2010
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