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WALGREEN CO.
CHC12887-00 ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS INC
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Covered Entity Details
Entity Name
ARKANSAS VERDIGRIS VALLEY HEALTH CENTERS INC
Subdivision Name
Arkansas Verdgris Valley Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12887-00
Entity Address
505 S Main
Porter, OK 74454-0334
Grant Number
H80CS12887
Participating Start Date
4/1/2011
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05529
2330 CHANDLER RD
MUSKOGEE, OK 74403
Pharmacy Comments
Contract Details
Approval Date
4/12/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James R. Turner, Chief Executive Officer
(918) 906-2871
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/12/2013
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