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WALGREEN CO
CH04518K COMMUNITY HEALTH CARE SYSTEMS INC
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CARE SYSTEMS INC
Subdivision Name
TriCounty Health System - Sparta
Type
HRSA-Funded Health Center
340B ID
CH04518K
Entity Address
675 HAMILTON ST
SPARTA, GA 31087-1837
Grant Number
H80CS00507
Participating Start Date
1/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11995
668 MAIN ST
THOMSON, GA 30824
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carla Belcher, CEO
(478) 552-7384 Ext: 1211
Contract Pharmacy Representative
Walgreens
Jim Guth, Regional Manager, 340B Client Relationship
(847) 964-4749
Signed By Date
7/15/2019
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