340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
RWI63139 Southampton Community Healthcare, Inc
Print
Covered Entity Details
Entity Name
Southampton Community Healthcare, Inc
Subdivision Name
Type
Ryan White Part A
340B ID
RWI63139
Entity Address
2340 Hampton Ave
Saint Louis, MO 63139
Grant Number
H89HA00033
Participating Start Date
1/1/2023
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15311
115 N EUCLID AVE STE A
SAINT LOUIS, MO 63108
Pharmacy Comments
Contract Details
Approval Date
1/2/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David James Prelutsky, President
(314) 276-3090
Contract Pharmacy Representative
Walgreens
Eric Ambroz, 340B Client Relationship Analyst
(847) 315-5357
Signed By Date
1/2/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session