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WALGREEN CO.
CH056820 COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
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Covered Entity Details
Entity Name
COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
Subdivision Name
DBA LISBON COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH056820
Entity Address
7880 Lincole Pl
Lisbon, OH 44432-8322
Grant Number
H80CS00197
Participating Start Date
7/1/1997
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09377
2124 E STATE ST
SALEM, OH 44460-2455
Pharmacy Comments
Contract Details
Approval Date
10/14/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jenna E Wonner, COO
(330) 424-7221 Ext: 103
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/14/2014
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