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WALGREEN CO.
CH043270 EAU CLAIRE COOPERATIVE HEALTH CENTER, INC.
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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
WALGREENS #17059
2300 DECKER BLVD
COLUMBIA, SC 29206
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
1/16/2023
Pharmacy closed
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
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