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WALGREEN CO.
STD303035 Empowerment Resource Center
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Covered Entity Details
Entity Name
Empowerment Resource Center
Subdivision Name
Comprehensive Intervention Clinic
Type
Sexually Transmitted Diseases
340B ID
STD303035
Entity Address
230 Peachtree St NW
Suite 1800
Atlanta, GA 30303-1514
Grant Number
5NH25PS004329-04-00
Participating Start Date
10/1/2013
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #13873
2675 N DECATUR ROAD STE 101
DECATUR, GA 30033
Pharmacy Comments
Contract Details
Approval Date
1/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/12/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jacqueline Brown, Chief Executive Officer
(404) 526-1145
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/17/2017
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