Contract Pharmacy Details

WALGREEN CO.
CH046900 MEDCURA HEALTH, INC.

Covered Entity Details

Entity Name

MEDCURA HEALTH, INC.

Subdivision Name

STONE MOUNTAIN

Type

HRSA-Funded Health Center

340B ID

CH046900

Entity Address

5582 MEMORIAL DRIVE
STONE MOUNTAIN, GA 30083

Grant Number

H80CS00179

Participating Start Date

4/1/2004

Last Recertification Date

2/16/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06205
2945 PANOLA ROAD
STONECREST, GA 30038

Pharmacy Comments

Contract Details

Approval Date

1/3/2012

Contract Begin Date

1/3/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/19/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

JEFF TAYLOR, CEO
(404) 298-3250

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/20/2012

340B Drug Pricing Program Database