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WALGREEN LOUISIANA CO., INC.
DSH190128 WOMAN'S HOSPITAL FOUNDATION DBA WOMAN'S HOSPITAL
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Covered Entity Details
Entity Name
WOMAN'S HOSPITAL FOUNDATION DBA WOMAN'S HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH190128
Entity Address
100 Woman's Way
BATON ROUGE, LA 70817
Medicare Provider Number
190128
Participating Start Date
11/8/2005
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 09860
5955 AIRLINE HWY
BATON ROUGE, LA 70805-3202
Pharmacy Comments
Contract Details
Approval Date
10/20/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/2/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Rene Ragas, President/CEO
(225) 924-8203
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/20/2022
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