340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
FQHCLA361A Adult and Child Mental Health Center, Inc
Print
Covered Entity Details
Entity Name
Adult and Child Mental Health Center, Inc
Subdivision Name
Adult and Child Heath - Northwood Plaza
Type
Health Center Program Look-Alike
340B ID
FQHCLA361A
Entity Address
1860 Northwood Plaza
Franklin, IN 46131-1037
Grant Number
LALCS31537
Participating Start Date
4/1/2018
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS SPECIALTY PHARMACY #16317
335 MASSACHUSETTS AVENUE
INDIANAPOLIS, IN 46204
Pharmacy Comments
Contract Details
Approval Date
4/9/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dan Arens, Chief Operating Officer
(317) 893-0336
Contract Pharmacy Representative
Adult and Child Health
Dan Arens, Chief Operating Officer
(317) 893-0336
Signed By Date
4/9/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session