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WALGREEN CO.
CH034100 PORTSMOUTH COMMUNITY HEALTH CENTER, INC.,d/b/a Hampton Roads Community Health Center
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Covered Entity Details
Entity Name
PORTSMOUTH COMMUNITY HEALTH CENTER, INC.,d/b/a Hampton Roads Community Health Center
Subdivision Name
PORTSMOUTH COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH034100
Entity Address
664 Lincoln St
Portsmouth, VA 23704-4818
Grant Number
H80CS00729
Participating Start Date
1/1/1994
Last Recertification Date
1/31/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16570
201 W 21ST ST STE 6
NORFOLK, VA 23517
Pharmacy Comments
Contract Details
Approval Date
10/5/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Barbara Willis, CEO
(757) 393-6363
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/5/2017
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