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WALGREENS SPECIALTY PHARMACY, LLC
CH074010 KONZA PRAIRIE COMMUNITY HEALTH CENTER INC
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Covered Entity Details
Entity Name
KONZA PRAIRIE COMMUNITY HEALTH CENTER INC
Subdivision Name
KONZA PRAIRIE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH074010
Entity Address
361 Grant Ave
Junction City, KS 66441-4201
Grant Number
H80CS00210
Participating Start Date
1/1/1997
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
1/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/25/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lee Wolf, Chief Executive Officer
(785) 238-4711 Ext: 201
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/17/2017
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