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WALGREEN CO.
CHC29004-00 HOWARD BROWN HEALTH CENTER
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Covered Entity Details
Entity Name
HOWARD BROWN HEALTH CENTER
Subdivision Name
Howard Brown Health Center-Clark
Type
HRSA-Funded Health Center
340B ID
CHC29004-00
Entity Address
6500 N Clark St
Chicago, IL 60626-4002
Grant Number
H80CS29004
Participating Start Date
4/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS 16299
331 W. SURF ST.
SUITE 101
CHICAGO, IL 60657-7160
Pharmacy Comments
Contract Details
Approval Date
4/6/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Kristin Keglovitz-Baker, SVP, Chief Operating Officer
(773) 388-8901
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/6/2017
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