Contract Pharmacy Details

WALGREENS MAIL SERVICE, LLC
CH010580 PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE

Covered Entity Details

Entity Name

PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE

Subdivision Name

PROVIDENCE COMMUNITY HEALTH CENTERS, INC.

Type

HRSA-Funded Health Center

340B ID

CH010580

Entity Address

375 Allens Ave
Providence, RI 02905-5010

Grant Number

H80CS00057

Participating Start Date

7/1/1996

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREENS MAIL SERVICE, LLC

Pharmacy Address

WALGREENS MAIL SERVICE #03397
8350 S RIVER PARKWAY
TEMPE, AZ 85284

Pharmacy Comments

Contract Details

Approval Date

10/5/2017

Contract Begin Date

1/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Garrett Clark, CO
(401) 444-0400

Contract Pharmacy Representative

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

Signed By Date

10/5/2017

340B Drug Pricing Program Database