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WALGREEN CO
CHC26511-06 UPPER GREAT LAKES FAMILY HEALTH CENTER
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Covered Entity Details
Entity Name
UPPER GREAT LAKES FAMILY HEALTH CENTER
Subdivision Name
Sawyer Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC26511-06
Entity Address
301 Explorer St
Gwinn, MI 49841
Grant Number
H80CS26511
Participating Start Date
7/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11953
300 EAST F STREET
IRON MOUNTAIN, MI 49801-3442
Pharmacy Comments
Contract Details
Approval Date
6/18/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald A. Simila, CEO
(906) 481-8571
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/18/2014
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