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WALGREEN CO.
CH050580 NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Subdivision Name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH050580
Entity Address
8300 Hough Ave
Cleveland, OH 44103-4247
Grant Number
H80CS00191
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03256
11401 UNION AVENUE
CLEVELAND, OH 44105
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Willie F. Austin, President/CEO
(216) 231-7700 Ext: 1112
Contract Pharmacy Representative
NEON
Anita Watson, Medical Director
(216) 231-7700 Ext: 1004
Signed By Date
4/13/2018
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