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WALGREEN LOUISIANA CO., INC.
CH063380 SWLA CENTER FOR HEALTH SERVICES
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Covered Entity Details
Entity Name
SWLA CENTER FOR HEALTH SERVICES
Subdivision Name
SOUTHWEST LOUISIANA CENTER FOR HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH063380
Entity Address
2000 Opelousas St
Lake Charles, LA 70601-2641
Grant Number
H80CS00558
Participating Start Date
10/1/2002
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 06219
2636 RYAN ST
LAKE CHARLES, LA 70601
Pharmacy Comments
Contract Details
Approval Date
4/14/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SHEIK BACCHUS, CEO
(337) 493-5115
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2014
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