340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
CH07731G COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC
Print
Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC
Subdivision Name
CHC/SEIA Keokuk Clinic
Type
HRSA-Funded Health Center
340B ID
CH07731G
Entity Address
1618 Main Street
Keokuk, IA 52632-3452
Grant Number
H80CS00272
Participating Start Date
10/1/2017
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11759
2639 AVENUE L
FORT MADISON, IA 52627-3840
Pharmacy Comments
Contract Details
Approval Date
7/14/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
RONALD KEMP, CEO
(319) 753-2300 Ext: 100
Contract Pharmacy Representative
Terri Ward, VP
(847) 964-6798
Signed By Date
7/14/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session