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WALGREENS.COM, INC.
CH010580 PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE
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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.COM, INC.
Pharmacy Address
DBA: WALGREENS
2225 S. PRICE ROAD
CHANDLER, AZ 85286
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
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