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WALGREEN LOUISIANA CO., INC.
DSH190040 Slidell Memorial Hospital
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Covered Entity Details
Entity Name
Slidell Memorial Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190040
Entity Address
1001 Gause Boulevard
Slidell, LA 70458-2987
Medicare Provider Number
190040
Participating Start Date
10/1/2011
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
WALGREENS #17049
2090 GAUSE BLVD E
SLIDELL, LA 70461-5431
Pharmacy Comments
Contract Details
Approval Date
10/8/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/8/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Sandy Badinger, Chief Executive Officer
(985) 280-8503
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/8/2019
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