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WALGREEN CO.
CHC29004-02 HOWARD BROWN HEALTH CENTER
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Covered Entity Details
Entity Name
HOWARD BROWN HEALTH CENTER
Subdivision Name
Howard Brown Sheridan
Type
HRSA-Funded Health Center
340B ID
CHC29004-02
Entity Address
4025 N Sheridan Rd
Chicago, IL 60613-2010
Grant Number
H80CS29004
Participating Start Date
7/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #16498
2351 E 71ST ST
SUITE A
CHICAGO, IL 60649
Pharmacy Comments
Contract Details
Approval Date
10/19/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/11/2018
Business decision by covered entity and/or pharmacy
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
10/19/2016
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