Contract Pharmacy Details

WALGREEN CO.
CHC26605-00 NORTHERN NEVADA HIV OUTPATIENT PROGRAM, EDUCATION AND SERVICES

Covered Entity Details

Entity Name

NORTHERN NEVADA HIV OUTPATIENT PROGRAM, EDUCATION AND SERVICES

Subdivision Name

Type

HRSA-Funded Health Center

340B ID

CHC26605-00

Entity Address

580 W 5th St
Reno, NV 89503-4432

Grant Number

H80CS26605

Participating Start Date

4/1/2014

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04610
18461 E HAMPDEN AVE
AURORA, CO 80013

Pharmacy Comments

Contract Details

Approval Date

1/6/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/11/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Sharon Chamberlain, Chief Executive Officer
(775) 348-2895

Contract Pharmacy Representative

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

Signed By Date

1/6/2017

340B Drug Pricing Program Database