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WALGREEN CO.
CH081460 PEAK VISTA COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
PEAK VISTA COMMUNITY HEALTH CENTERS
Subdivision Name
Peak Vista Administrative Services Center
Type
HRSA-Funded Health Center
340B ID
CH081460
Entity Address
3205 N Academy Blvd Ste 130
Colorado Springs, CO 80917
Grant Number
H80CS00212
Participating Start Date
12/1/1992
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12769
265 W HIGHWAY 105
MONUMENT, CO 80132
Pharmacy Comments
Contract Details
Approval Date
8/3/2012
Contract Begin Date
8/3/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Pamela J. McManus, President & CEO
(719) 344-6450
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/19/2012
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