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WALGREEN CO
FP30303 Empowerment Resource Center
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Covered Entity Details
Entity Name
Empowerment Resource Center
Subdivision Name
Comprehensive Intervention Clinic
Type
Family Planning (Title X only)
340B ID
FP30303
Entity Address
230 Peachtree St NW
SUITE 1800
ATLANTA, GA 30303-1514
Grant Number
FPHPA046164
Participating Start Date
4/1/2016
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #12604
340 BOULEVARD NE STE 143
ATLANTA, GA 30312
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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