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WALGREEN CO
CH04518T Community Health Care Systems Inc
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Covered Entity Details
Entity Name
Community Health Care Systems Inc
Subdivision Name
Community Health Care Systems, Inc. - Taliaferro
Type
HRSA-Funded Health Center
340B ID
CH04518T
Entity Address
557A Broad St NW
Crawfordville, GA 30631-2918
Grant Number
H80CS00507
Participating Start Date
7/1/2019
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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