Contract Pharmacy Details

WALGREEN CO.
CH053060 Sixteenth Street Community Health Centers, Inc.

Covered Entity Details

Entity Name

Sixteenth Street Community Health Centers, Inc.

Subdivision Name

Sixteenth Street Community Health Centers-Chavez

Type

HRSA-Funded Health Center

340B ID

CH053060

Entity Address

1032 S Cesar E Chavez Dr
MILWAUKEE, WI 53204

Grant Number

H80CS00593

Participating Start Date

10/1/1996

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06058
4296 S 76TH STREET
GREENFIELD, WI 53220

Pharmacy Comments

Contract Details

Approval Date

4/5/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Betsy Spahiu, Vice President Finance
(414) 897-5153

Contract Pharmacy Representative

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

Signed By Date

4/5/2018

340B Drug Pricing Program Database