Contract Pharmacy Details

WALGREEN CO.
RWI303041 FULTON COUNTY BOARD OF HEALTH

Covered Entity Details

Entity Name

FULTON COUNTY BOARD OF HEALTH

Subdivision Name

Fulton County Public Health at 10 Park Place

Type

Ryan White Part A

340B ID

RWI303041

Entity Address

10 PARK PLACE SOUTH S.E.
ATLANTA, GA 30303

Grant Number

H89HA00007

Participating Start Date

12/1/1992

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 07608
5435 FIVE FORKS TRICKUM ROAD
STONE MOUNTAIN, GA 30087

Pharmacy Comments

Contract Details

Approval Date

4/15/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lynn Paxton, District Health Director
(404) 613-1059

Contract Pharmacy Representative

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

Signed By Date

4/15/2024

340B Drug Pricing Program Database