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WALGREEN LOUISIANA CO., INC.
DSH190046 TOURO INFIRMARY
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Covered Entity Details
Entity Name
TOURO INFIRMARY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190046
Entity Address
1401 FOUCHER STREET
NEW ORLEANS, LA 70115
Medicare Provider Number
190046
Participating Start Date
4/1/2006
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS #04982
7401 READ BLVD
NEW ORLEANS, LA 70127
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/29/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Susan Pitoscia, Vice President/COO
(504) 897-8452
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2015
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