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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 # 10207
152 N BUCKMAN ST
SHEPHERDSVILLE, KY 40165-4900
Pharmacy Comments
Contract Details
Approval Date
10/12/2012
Contract Begin Date
10/12/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BILL B WAGNER, CEO
(502) 778-4201
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/4/2012
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