Contract Pharmacy Details

WALGREEN CO.
CHC02456-00 WINDROSE HEALTH NETWORK, INC.

Covered Entity Details

Entity Name

WINDROSE HEALTH NETWORK, INC.

Subdivision Name

Windrose Health Network - Trafalgar

Type

HRSA-Funded Health Center

340B ID

CHC02456-00

Entity Address

14 Trafalgar Sq
Trafalgar, IN 46181-9515

Grant Number

H80CS02456

Participating Start Date

10/1/2016

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #21257
902 E HANNA AVE
INDIANAPOLIS, IN 46227

Pharmacy Comments

Contract Details

Approval Date

1/4/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Scott K Rollett, CEO
(317) 739-4895 Ext: 2401

Contract Pharmacy Representative

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

Signed By Date

1/4/2018

340B Drug Pricing Program Database