Contract Pharmacy Details

WALGREEN CO.
CH043270 EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.

Covered Entity Details

Entity Name

EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.

Subdivision Name

EAU CLAIRE COOPERATIVE HEALTH CENTER ADMINISTRATIVE OFFICES

Type

HRSA-Funded Health Center

340B ID

CH043270

Entity Address

221 Dawson Road
COLUMBIA, SC 29223

Grant Number

H80CS00730

Participating Start Date

4/1/2002

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

RITE AID #11588
7900 GARNERS FERRY RD
COLUMBIA, SC 29209

Pharmacy Comments

Contract Details

Approval Date

4/12/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/8/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

DELGADO CANTAVE, CEO
(803) 733-5969 Ext: 4146

Contract Pharmacy Representative

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

Signed By Date

4/12/2018

340B Drug Pricing Program Database