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WALGREENS SPECIALTY PHARMACY, LLC
CHC08239-00 PRAIRIESTAR HEALTH CENTER INC
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Covered Entity Details
Entity Name
PRAIRIESTAR HEALTH CENTER INC
Subdivision Name
PRAIRIESTAR HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CHC08239-00
Entity Address
2700 E 30TH AVE
HUTCHINSON, KS 67502
Grant Number
H80CS08239
Participating Start Date
4/1/2012
Last Recertification Date
2/12/2025
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
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bryant Anderson, Chief Executive Officer
(620) 802-0035
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/13/2017
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