Contract Pharmacy Details

WALGREEN CO.
FQHCLA404 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 Community Care Clinic

Type

Health Center Program Look-Alike

340B ID

FQHCLA404

Entity Address

1000 E. 3rd Street Ste 300
Chattanooga, TN 37403-2153

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 # 07312
4810 ROSSVILLE BLVD
CHATTANOOGA, TN 37407-3524

Pharmacy Comments

Contract Details

Approval Date

2/18/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/9/2024
Pharmacy closed

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