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WALGREEN CO.
FQHCLA372 CARETEAM PLUS, INC.
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Covered Entity Details
Entity Name
CARETEAM PLUS, INC.
Subdivision Name
Careteam + Family Health and Specialty Care
Type
Health Center Program Look-Alike
340B ID
FQHCLA372
Entity Address
100 Professional Park Dr
Conway, SC 29526-9260
Grant Number
LALCS31819
Participating Start Date
10/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07154
1601 CHURCH STREET
CONWAY, SC 29526-2959
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Johanna Haynes, Executive Director
(843) 234-8220
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2019
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