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WALGREEN CO.
CHC08784-00 LAKES COMMUNITY HEALTH CENTER, INC., THE
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Covered Entity Details
Entity Name
LAKES COMMUNITY HEALTH CENTER, INC., THE
Subdivision Name
NorthLakes - Iron River
Type
HRSA-Funded Health Center
340B ID
CHC08784-00
Entity Address
7665 Us Highway 2
Iron River, WI 54847-4690
Grant Number
H80CS08784
Participating Start Date
7/1/2010
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03064
2015 TOWER AVENUE
SUPERIOR, WI 54880
Pharmacy Comments
Contract Details
Approval Date
8/9/2011
Contract Begin Date
8/30/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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