Contract Pharmacy Details

WALGREEN CO.
FP60901 AUNT MARTHA'S COMUNITY HEALTH CENTER

Covered Entity Details

Entity Name

AUNT MARTHA'S COMUNITY HEALTH CENTER

Subdivision Name

KANKAKEE COMMUNITY HEALTH CENTER

Type

Family Planning (Title X only)

340B ID

FP60901

Entity Address

1777 COURT ST.
KANAKEE, IL 60901

Grant Number

FPHPA006459

Participating Start Date

4/1/2020

Last Recertification Date

5/12/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09357
833 W 115TH ST
CHICAGO, IL 60643-4619

Pharmacy Comments

Contract Details

Approval Date

4/17/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Audrey Pennington, Chief Operating Officer
(708) 747-7100

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/17/2017

340B Drug Pricing Program Database