340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
CHC26576-02 Dayton Health Centers dba Five Rivers Health Centers
Print
Covered Entity Details
Entity Name
Dayton Health Centers dba Five Rivers Health Centers
Subdivision Name
Five Rivers Health Centers Edgemont Campus
Type
HRSA-Funded Health Center
340B ID
CHC26576-02
Entity Address
721 Miami Chapel Road
Dayton, OH 45417
Grant Number
H80CS26576
Participating Start Date
10/1/2014
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04520
1260 E CENTRAL
MIAMISBURG, OH 45342
Pharmacy Comments
Contract Details
Approval Date
10/1/2014
Contract Begin Date
10/3/2014
Carve-In Effective Date
Contract Comments
10/03/2014 Immediate Begin Date authorized
Contacts
Covered Entity Signing Official
Dave Bridge, CFO
(937) 734-6844
Contract Pharmacy Representative
Elizabeth Cervera, 340B Operations Analyst
(847) 964-8159
Signed By Date
10/1/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session