Contract Pharmacy Details

WALGREEN LOUISIANA CO., INC.
DSH190019 CHRISTUS ST FRANCES CABRINI HOSPITAL

Covered Entity Details

Entity Name

CHRISTUS ST FRANCES CABRINI HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH190019

Entity Address

3330 MASONIC DRIVE
ALEXANDRIA, LA 71301

Medicare Provider Number

190019

Participating Start Date

4/1/2006

Last Recertification Date

8/16/2024

Pharmacy Details

Pharmacy Name

WALGREEN LOUISIANA CO., INC.

Pharmacy Address

DBA: WALGREENS # 01657
3333 MASONIC DRIVE
ALEXANDRIA, LA 71301

Pharmacy Comments

Contract Details

Approval Date

10/25/2012

Contract Begin Date

10/25/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Stephen F. Wright, President and CEO
(318) 448-6701

Contract Pharmacy Representative

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

Signed By Date

10/10/2012

340B Drug Pricing Program Database