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WALGREEN CO.
RRC230022-00 COMMUNITY HEALTH CENTER BRANCH CTY
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER BRANCH CTY
Subdivision Name
Type
Rural Referral Center
340B ID
RRC230022-00
Entity Address
274 EAST CHICAGO STREET
COLDWATER, MI 49036
Medicare Provider Number
230022
Participating Start Date
7/1/2015
Last Recertification Date
11/16/2017
Entity Termination Date
4/1/2018
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09130
5991 BECKLEY RD
BATTLE CREEK, MI 49014
Pharmacy Comments
Contract Details
Approval Date
1/18/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Randy DeGroot, CEO
(517) 279-5489
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/18/2017
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