Contract Pharmacy Details

WALGREEN CO.
CH053210 ERIE FAMILY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

ERIE FAMILY HEALTH CENTER, INC.

Subdivision Name

ERIE WEST TOWN HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH053210

Entity Address

1701 W Superior St
Chicago, IL 60622

Grant Number

H80CS00115

Participating Start Date

1/1/1997

Last Recertification Date

2/23/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 00232
3405 S KING DR
CHICAGO, IL 60616

Pharmacy Comments

9/27/10 UPDATED PHARMACY NAME (WAS WALGREENS #245);

Contract Details

Approval Date

4/14/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/26/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

David Bruce, Chief Financial & Administrative Officer (CFAO)
(312) 432-2725

Contract Pharmacy Representative

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

Signed By Date

4/14/2018

340B Drug Pricing Program Database