Contract Pharmacy Details

WALGREEN CO.
CH051030 TCA HEALTH, INC. NFP

Covered Entity Details

Entity Name

TCA HEALTH, INC. NFP

Subdivision Name

THE CLINIC IN ALTGELD, INC.

Type

HRSA-Funded Health Center

340B ID

CH051030

Entity Address

1029 E 130th St
Chicago, IL 60628-6908

Grant Number

H80CS00109

Participating Start Date

10/1/1997

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05124
8628 S COTTAGE GROVE AVE
CHICAGO, IL 60619

Pharmacy Comments

Contract Details

Approval Date

4/15/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

VERONICA CLARKE, CEO
(773) 995-6300 Ext: 213

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/15/2016

340B Drug Pricing Program Database