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WALGREEN CO.
CH051278J Tapestry 360 Health
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Covered Entity Details
Entity Name
Tapestry 360 Health
Subdivision Name
Tapestry 360 Health - Hibbard
Type
HRSA-Funded Health Center
340B ID
CH051278J
Entity Address
3244 W Ainslie St
Chicago, IL 60625-5018
Grant Number
H80CS00215
Participating Start Date
10/1/2010
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #16498
2351 E 71ST ST
SUITE A
CHICAGO, IL 60649
Pharmacy Comments
Contract Details
Approval Date
10/17/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
CE terminated due to audit finding
Contacts
Covered Entity Signing Official
Gwenn Rausch, CEO
(773) 296-7587
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/17/2017
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