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WALGREEN CO.
CH041260 ERLANGER HEALTH SYSTEM SOUTHSIDE/DODSON AVE CHC
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Covered Entity Details
Entity Name
ERLANGER HEALTH SYSTEM SOUTHSIDE/DODSON AVE CHC
Subdivision Name
SOUTHSIDE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH041260
Entity Address
3800 Tennessee Ave.
Suite 124
CHATTANOOGA, TN 37409
Grant Number
H80CS00091
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07312
4810 ROSSVILLE BLVD
CHATTANOOGA, TN 37407-3524
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/9/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
BRITTON J. TABOR, CFO
(423) 778-7729
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2020
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