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WALGREEN LOUISIANA CO., INC.
RW426264B NO/AIDS Task Force (d.b.a. CrescentCare)
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Covered Entity Details
Entity Name
NO/AIDS Task Force (d.b.a. CrescentCare)
Subdivision Name
Family Care Services Center
Type
Ryan White Part D
340B ID
RW426264B
Entity Address
1631 ELYSIAN FIELDS AVE
New Orleans, LA 70117
Grant Number
H12HA26264
Participating Start Date
1/1/2015
Last Recertification Date
2/11/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
WALGREEN LOUISIANA CO., INC.
Pharmacy Address
DBA: WALGREENS # 02262
1100 ELYSIAN FIELDS
NEW ORLEANS, LA 70117
Pharmacy Comments
Contract Details
Approval Date
1/14/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
NOEL John TWILBECK, CEO
(504) 821-2601 Ext: 1000
Contract Pharmacy Representative
Avita Drugs
JERRY PURCELL, FOUNDER
(504) 905-4587
Signed By Date
1/14/2018
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