Contract Pharmacy Details

WALGREEN CO.
FQHCLA404A CHATTANOOGA C.A.R.E.S. DBA CEMPA COMMUNITY CARE

Covered Entity Details

Entity Name

CHATTANOOGA C.A.R.E.S. DBA CEMPA COMMUNITY CARE

Subdivision Name

Cempa Mobile Health Clinic

Type

Health Center Program Look-Alike

340B ID

FQHCLA404A

Entity Address

1000 E. Third Street
Chattanooga, TN 37403

Grant Number

LALCS33899

Participating Start Date

3/17/2020

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #11732
2900 PAUL HUFF PKWY. NW
CLEVELAND, TN 37312-3076

Pharmacy Comments

Contract Details

Approval Date

2/28/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Shannon Stephenson, CEO
(423) 648-9911

Contract Pharmacy Representative

Walgreens
Sharon Huiett, Analyst, 340B Client Relationship
(847) 964-8687

Signed By Date

2/15/2020

340B Drug Pricing Program Database