Contract Pharmacy Details

WALGREEN CO.
CHC08748-00 COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI

Subdivision Name

Jefferson City Clinic

Type

HRSA-Funded Health Center

340B ID

CHC08748-00

Entity Address

3400 W Truman Blvd
Jefferson City, MO 65109-5712

Grant Number

H80CS08748

Participating Start Date

1/1/2011

Last Recertification Date

2/9/2018

Entity Termination Date

10/1/2018

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09713
3740 W TRUMAN BLVD
JEFFERSON CITY, MO 65109-0537

Pharmacy Comments

Contract Details

Approval Date

7/11/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2018
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Toby Barnett, CFO
(573) 632-0243

Contract Pharmacy Representative

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

Signed By Date

7/11/2016

340B Drug Pricing Program Database