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WALGREEN CO.
CH043340 CareConnect Health, Inc.
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Covered Entity Details
Entity Name
CareConnect Health, Inc.
Subdivision Name
CareConnect Family Practice and Pediatrics
Type
HRSA-Funded Health Center
340B ID
CH043340
Entity Address
510 Alston Street
Suite A
Richland, GA 31825-1404
Grant Number
H80CS00393
Participating Start Date
4/1/2002
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11793
1100 BALL STREET
PERRY, GA 31069
Pharmacy Comments
Contract Details
Approval Date
1/4/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/27/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Ajay Gehlot, CEO
(229) 273-8881
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/4/2017
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