Contract Pharmacy Details

WALGREEN CO.
CHC26601-00 Full Circle Health, Inc.

Covered Entity Details

Entity Name

Full Circle Health, Inc.

Subdivision Name

Full Circle Health - Meridian

Type

HRSA-Funded Health Center

340B ID

CHC26601-00

Entity Address

2275 S Eagle Rd STE 120
Meridian, ID 83642-2620

Grant Number

H80CS26601

Participating Start Date

4/1/2014

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 01972
6725 N GLENWOOD ST
BOISE, ID 83714

Pharmacy Comments

Contract Details

Approval Date

4/3/2015

Contract Begin Date

7/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Ted Epperly, President and CEO
(208) 954-8745

Contract Pharmacy Representative

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

Signed By Date

4/3/2015

340B Drug Pricing Program Database