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WALGREEN CO
CH01208U COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
WYA at Masters Manna
Type
HRSA-Funded Health Center
340B ID
CH01208U
Entity Address
46 North Plain Industrial Road
Wallingford, CT 06492
Grant Number
H80CS00326
Participating Start Date
10/1/2012
Last Recertification Date
2/9/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS
28727 OREGON ROAD
PERRYSBURG, OH 43551
Pharmacy Comments
ATTN: C II manager
Contract Details
Approval Date
12/10/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/12/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mark Masselli, President and CEO
(860) 347-6971
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2012
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