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WALGREENS SPECIALTY PHARMACY, LLC
CHC28357-00 NORTH OLYMPIC HEALTHCARE NETWORK PC
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Covered Entity Details
Entity Name
NORTH OLYMPIC HEALTHCARE NETWORK PC
Subdivision Name
North Olympic Healthcare Network PC
Type
HRSA-Funded Health Center
340B ID
CHC28357-00
Entity Address
240 W FRONT ST
PORT ANGELES, WA 98362-2609
Grant Number
H80CS28357
Participating Start Date
1/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
10/13/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen J Paulsen, Project Director
(360) 452-7891 Ext: 2829
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2017
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