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WALGREEN CO
CHC08221-00 HEART CITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
HEART CITY HEALTH CENTER, INC.
Subdivision Name
HEART CITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC08221-00
Entity Address
236 Simpson Ave
Elkhart, IN 46516-4671
Grant Number
H80CS08221
Participating Start Date
4/1/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11795
3551 CASSOPOLIS STREET
ELKHART, IN 46514-6743
Pharmacy Comments
Contract Details
Approval Date
10/10/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
VERNITA TODD, CEO
(574) 293-0052
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/10/2013
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