Contract Pharmacy Details

WALGREEN CO
CHC26567-00 MERIDIAN SERVICES CORP

Covered Entity Details

Entity Name

MERIDIAN SERVICES CORP

Subdivision Name

Meridian Health Services

Type

HRSA-Funded Health Center

340B ID

CHC26567-00

Entity Address

240 N Tillotson Ave
Muncie, IN 47304-3988

Grant Number

H80CS26567

Participating Start Date

4/1/2016

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO

Pharmacy Address

DBA: WALGREENS #10533
3250 N MORRISON ROAD
MUNCIE, IN 47304

Pharmacy Comments

Contract Details

Approval Date

1/5/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Amelia Clark, VP Community Health
(765) 254-5102

Contract Pharmacy Representative

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

Signed By Date

1/5/2017

340B Drug Pricing Program Database