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WALGREEN LOUISIANA CO., INC.
CHC28963-01 PRIORITY HEALTH CARE
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Covered Entity Details
Entity Name
PRIORITY HEALTH CARE
Subdivision Name
Priority Health Care-Gretna
Type
HRSA-Funded Health Center
340B ID
CHC28963-01
Entity Address
12 Westbank Expressway
Gretna, LA 70053-3659
Grant Number
H80CS28963
Participating Start Date
7/1/2016
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 03889
4110 GENERAL DEGAULLE DR
NEW ORLEANS, LA 70131
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tamara Boutte, Chief Executive Officer
(504) 309-6522
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2018
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