Contract Pharmacy Details

WALGREEN CO
CHC28352-00 ISABELLA CITIZENS FOR HEALTH, INC.

Covered Entity Details

Entity Name

ISABELLA CITIZENS FOR HEALTH, INC.

Subdivision Name

Isabella Citizens for Health

Type

HRSA-Funded Health Center

340B ID

CHC28352-00

Entity Address

2940 Health Pkwy
Mount Pleasant, MI 48858-9342

Grant Number

H80CS28352

Participating Start Date

4/1/2016

Last Recertification Date

2/4/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

WALGREEN CO

Pharmacy Address

DBA: WALGREENS #11887
1141 N MCEWAN ST
CLARE, MI 48617-1107

Pharmacy Comments

Contract Details

Approval Date

4/11/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Jennifer White, Chief Executive Officer
(989) 953-5191 Ext: 1

Contract Pharmacy Representative

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

Signed By Date

4/11/2016

340B Drug Pricing Program Database