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WALGREEN CO.
CH05183M INGHAM, COUNTY OF
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Covered Entity Details
Entity Name
INGHAM, COUNTY OF
Subdivision Name
Birch Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH05183M
Entity Address
812 E Jolly Rd
Ste 112
Lansing, MI 48910-6818
Grant Number
H80CS00030
Participating Start Date
4/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06369
410 E JOLLY ROAD
LANSING, MI 48910-6649
Pharmacy Comments
Contract Details
Approval Date
3/13/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Janice Speakman, 340B Implementation Analyst
(847) 964-6823
Signed By Date
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