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WALGREENS MAIL SERVICE, INC.
CH010150 COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.
Subdivision Name
Riverside Health Center
Type
HRSA-Funded Health Center
340B ID
CH010150
Entity Address
617 Riverside Ave
Burlington, VT 05401-1601
Grant Number
H80CS00311
Participating Start Date
7/1/1995
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, INC.
Pharmacy Address
8337 S PARK CIRCLE
ORLANDO, FL 32819-9049
Pharmacy Comments
Contract Details
Approval Date
1/13/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/10/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jack Donnelly, CEO
(802) 864-6309
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/13/2015
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