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WALGREEN CO.
CHC26565-00 Hamdard Health Alliance
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Covered Entity Details
Entity Name
Hamdard Health Alliance
Subdivision Name
Hamdard Health Addison
Type
HRSA-Funded Health Center
340B ID
CHC26565-00
Entity Address
228 E Lake St
Addison, IL 60101-2889
Grant Number
H80CS26565
Participating Start Date
4/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15197
6121 N BROADWAY ST.
CHICAGO, IL 60660
Pharmacy Comments
Contract Details
Approval Date
4/21/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kiran S. Siddique, COO
(773) 465-4600 Ext: 227
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/21/2015
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