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WALGREEN LOUISIANA CO., INC.
HV12908A NO/AIDS Task Force
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Covered Entity Details
Entity Name
NO/AIDS Task Force
Subdivision Name
CrescentCare Mid-City
Type
Ryan White Part C
340B ID
HV12908A
Entity Address
2515 Canal Street
New Orleans, LA 70119
Grant Number
H76HA12908
Participating Start Date
1/1/2015
Last Recertification Date
3/7/2025
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 05551
619 DECATUR ST
NEW ORLEANS, LA 70130
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/8/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
NOEL John TWILBECK, CEO
(504) 821-2601 Ext: 1000
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/14/2021
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