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WALGREEN CO
CHC24172-00 CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
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Covered Entity Details
Entity Name
CHRIST COMMUNITY HEALTH SERVICES AUGUSTA, INC.
Subdivision Name
Christ Community Health: Medical District CHC
Type
HRSA-Funded Health Center
340B ID
CHC24172-00
Entity Address
1226 Dantignac St
Augusta, GA 30901-2788
Grant Number
H80CS24172
Participating Start Date
7/1/2013
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA; WALGREENS #12107
400 S LIBERTY ST
WAYNESBORO, GA 30830
Pharmacy Comments
Contract Details
Approval Date
7/14/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas J. Drake III, Executive Director
(706) 922-3017
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2019
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