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WALGREEN LOUISIANA CO., INC.
CHC28963-02 PRIORITY HEALTH CARE
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Covered Entity Details
Entity Name
PRIORITY HEALTH CARE
Subdivision Name
Priority Health Care Pediatric Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28963-02
Entity Address
12A Westbank Expressway
101
Gretna, LA 70053
Grant Number
H80CS28963
Participating Start Date
7/1/2019
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 05633
2570 BARATARIA BLVD
MARRERO, LA 70072
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tamara B Dioubate, CEO
(504) 309-6522
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/13/2022
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