340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN LOUISIANA CO., INC.
DSH190013A WEST CALCASIEU-CAMERON HOSPITAL
Print
Covered Entity Details
Entity Name
WEST CALCASIEU-CAMERON HOSPITAL
Subdivision Name
ENT ASSOC W CALCASIEU CAMERON HOSPI - ENT Associates of West Calcasieu Cameron Hospital
Type
Disproportionate Share Hospital
340B ID
DSH190013A
Entity Address
1629 Beglis Parkway
SULPHUR, LA 70663-5641
Medicare Provider Number
190013
Outpatient Facility Provider Number
Participating Start Date
10/1/2018
Last Recertification Date
9/4/2020
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 10509
105 N CITIES SERVICE HWY
SULPHUR, LA 70663-5419
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jobie James, Chief Financial Officer
(337) 527-4143
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2018
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