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WALGREEN LOUISIANA CO., INC.
CHC28962-00 HIV/AIDS ALLIANCE FOR REGION TWO, INC.
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Covered Entity Details
Entity Name
HIV/AIDS ALLIANCE FOR REGION TWO, INC.
Subdivision Name
North Blvd Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28962-00
Entity Address
3801 North Blvd.
BATON ROUGE, LA 70806
Grant Number
H80CS28962
Participating Start Date
4/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16478
5555 ESSEN LN STE C
BATON ROUGE, LA 70809
Pharmacy Comments
Contract Details
Approval Date
1/11/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Timothy Young, Chief Executive Officer
(225) 927-1269
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2017
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