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WALGREEN CO
CH046900 MEDCURA HEALTH, INC.
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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 #10479
1783 HIGHWAY 138 SE
CONYERS, GA 30013
Pharmacy Comments
Contract Details
Approval Date
10/2/2014
Contract Begin Date
1/1/2015
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, Chief Executive Officer
(404) 298-3250
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/2/2014
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