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WALGREEN CO.
STD63144 NOVUS Health Inc.
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Covered Entity Details
Entity Name
NOVUS Health Inc.
Subdivision Name
University Club Medical
Type
Sexually Transmitted Diseases
340B ID
STD63144
Entity Address
1520 S Brentwood Blvd.
St. Louis, MO 63144
Grant Number
NH25PS005142
Participating Start Date
1/1/2020
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16552
628 N NEW BALLAS RD STE A
CREVE COEUR, MO 63141
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
4/27/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Alan Parks, Vice President
(314) 882-8855
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2020
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