Contract Pharmacy Details

WALGREEN CO.
CHC29004-01 HOWARD BROWN HEALTH CENTER

Covered Entity Details

Entity Name

HOWARD BROWN HEALTH CENTER

Subdivision Name

Howard Brown Halsted

Type

HRSA-Funded Health Center

340B ID

CHC29004-01

Entity Address

3245 N Halsted St
Chicago, IL 60657-0419

Grant Number

H80CS29004

Participating Start Date

7/1/2016

Last Recertification Date

2/3/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #13798
5440 N. CLARK ST.
CHICAGO, IL 60640

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

10/11/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

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

Signed By Date

340B Drug Pricing Program Database