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WALGREEN CO.
CH11355-00 FIRST CARE CLINIC, INC.
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Covered Entity Details
Entity Name
FIRST CARE CLINIC, INC.
Subdivision Name
First Care Clinic, Inc.
Type
HRSA-Funded Health Center
340B ID
CH11355-00
Entity Address
105 W. 13th Street
Hays, KS 67601
Grant Number
H80CS12891
Participating Start Date
10/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06285
2600 VINE STREET
HAYS, KS 67601
Pharmacy Comments
Contract Details
Approval Date
10/17/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bryan Brady, CEO
(785) 621-4990
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/17/2016
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