Contract Pharmacy Details

WALGREEN CO.
RWI30309 Positive Impact Health Centers, Inc.

Covered Entity Details

Entity Name

Positive Impact Health Centers, Inc.

Subdivision Name

Type

Ryan White Part A

340B ID

RWI30309

Entity Address

523 Church St
Decatur, GA 30030

Grant Number

H89HA00007

Participating Start Date

7/1/2014

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 07546
2075 GRAYSON HWY
GRAYSON, GA 30017-1242

Pharmacy Comments

Contract Details

Approval Date

7/20/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Larry M. Lehman, CEO
(678) 990-6450

Contract Pharmacy Representative

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

Signed By Date

7/20/2015

340B Drug Pricing Program Database