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WAL-MART PHARMACY 10-0540
CH06018G Teche Action Board, The
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Covered Entity Details
Entity Name
Teche Action Board, The
Subdivision Name
Teche Action Clinic @ Pierre Part
Type
HRSA-Funded Health Center
340B ID
CH06018G
Entity Address
3528 Hwy 70 South
Pierre Part, LA 70339
Grant Number
H80CS00767
Participating Start Date
7/1/2009
Last Recertification Date
3/9/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0540
Pharmacy Address
973 HIGHWAY 90 E
MORGAN CITY, LA 70380-5156
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/16/2024
Agreement registered in error
Contacts
Covered Entity Signing Official
Nikina Vilcan, CFO
(337) 828-2550 Ext: 2146
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/16/2024
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