Covered Entity Details

DSH030024 ST JOSEPH'S HOSPITAL AND MEDICAL CENTER (Active) - information as of 4/29/2025 11:51:05 PM

Main Details

Name

ST JOSEPH'S HOSPITAL AND MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH030024

Medicare Provider Number

030024

Additional Details

Current Program Status

Active

Registration Date

8/23/2007

Participating Start Date

1/1/2005

Participating Approval Date

8/23/2007

Last Recertification Date

8/18/2024

Contacts

Authorizing Official

St.Joseph's Hospital and Medical Center
Jeffrey Jackson, Chief Financial Officer
(602) 406-4618

Primary Contact

CommonSpirit Health - Central Region
Mitchell Schultz, RPh, 340b Regional Manager
(701) 928-0620

Addresses

Street Address

350 W THOMAS ROAD
PHOENIX, AZ 85013

Billing Address

Dignity Health Accounts Payable
3033 N. 3rd Avenue
Phoenix, AZ 85013

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
3/8/12 update zipcode last digit from 4 to 3 and add new shipping addresses	03/08/2012

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
AZ	691974	1982733655

Shipping Addresses

Shipping Address 1

St. Joseph's Hospital and Medical Center
350 W. Thomas Rd
Phoenix, AZ 85013

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/17/2019	10/01/2019		10/01/2019
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/17/2019	10/01/2019		10/01/2019
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/17/2019	10/01/2019		10/01/2019
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/17/2019	10/01/2019		10/01/2019
Contract Detail	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	07/17/2019	10/01/2019		10/01/2019
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/17/2019	10/01/2019		10/01/2019
Contract Detail	BIOPLUS SPECIALTY INFUSION CA, LLC	19110 VAN NESS AVE.		TORRANCE	CA	90501	07/17/2019	10/01/2019	02/26/2021	12/09/2021
Contract Detail	BIOPLUS SPECIALTY INFUSION TX, LLC	1748 N GREENVILLE AVE		RICHARDSON	TX	75081	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	BIOPLUS SPECIALTY PHARMACY CA	7373 LINCOLN WAY		GARDEN GROVE	CA	92841	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	BIOPLUS SPECIALTY PHARMACY LA, LLC	2731 MANHATTAN BLVD STE B17		HARVEY	LA	70058	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	BIOPLUS SPECIALTY PHARMACY, INC	3200 LAKE EMMA RD UNIT 1000		LAKE MARY	FL	32746	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	BRIOVARX OF MAINE INC	DBA BRIOVARX	53 DARLING AVE	SOUTH PORTLAND	ME	04106	10/14/2019	01/01/2020	10/01/2019	02/08/2021
Contract Detail	BRIOVARX OF MASSACHUSETTS, LLC	D/B/A BRIOVARX	BLDG 2 - UNIT A 145 BODWELL STREET	AVON	MA	02322	10/14/2019	01/01/2020	10/01/2019	02/08/2021
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	07/17/2019	10/01/2019	09/30/2019	10/14/2019
Contract Detail	KROGER SPECIALTY PHARMACY FL 2	6435 HAZELTINE NATIONAL DR STE 140		ORLANDO	FL	32822-5156	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	KROGER SPECIALTY PHARMACY INC	KROGER SPECIALTY PHARMACY CA 3	1821 KAISER AVE	IRVINE	CA	92614-5707	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	OPTUM FRONTIER THERAPIES II, LLC	6425 SANTA MARGARITA ST UNIT 110		LAS VEGAS	NV	89118-1913	10/14/2019	01/01/2020	12/01/2020	03/22/2021
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	10/14/2019	01/01/2020		01/01/2020
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	10/14/2019	01/01/2020		01/01/2020
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	10/14/2019	01/01/2020		01/01/2020
Contract Detail	OPTUM PHARMACY 800, INC.	3016 GUADALUPE ST STE A		AUSTIN	TX	78705-2861	10/14/2019	01/01/2020		01/01/2020
Contract Detail	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	10/14/2019	01/01/2020		01/01/2020
Contract Detail	OPTUM PHARMACY 806, INC.	2288 AUBURN BLVD	STE. 102	SACRAMENTO	CA	95821-1618	10/14/2019	01/01/2020		01/01/2020
Contract Detail	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	10/14/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	SMITH FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #12	18420 N. 19TH AVE	PHOENIX	AZ	85023	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD & DRUG	DBA FRY'S FOOD AND DRUG #113	1245 W MAIN STREET	MESA	AZ	85201	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD & DRUG CENTERS, INC.	FRY'S PHARMACY #112	1575 N DYSART ROAD	AVONDALE	AZ	85392	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD & DRUG CENTERS, INC.	D/B/A FRYS PHARMACY #45	7455 W CACTUS RD	PEORIA	AZ	85381	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD & DRUG CTRS	DBA FRY'S FOOD STORES #89	11425 W BUCKEYE RD	AVONDALE	AZ	85323	07/17/2019	10/01/2019	02/26/2021	12/09/2021
Contract Detail	SMITH'S FOOD & DRUG CTRS	DBA FRYS PHARMACY #72	87 E. WILLIAMS FIELD RD	GILBERT	AZ	85295	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD & DRUG CTRS	DBA FRY'S FOOD AND DRUG #123	2727 E BROADWAY	MESA	AZ	85204	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD & DRUG CTRS	DBA FRY'S FOOD AND DRUG #127	4202 WEST CACTUS RD	PHOENIX	AZ	85029	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD & DRUG CTRS	DBA FRY'S FOOD AND DRUG #136	4329 W NORTHERN AVE	GLENDALE	AZ	85301	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITH'S FOOD & DRUG CTRS INC	DBA FRY'S FOOD AND DRUG #124	3255 SO RURAL ROAD ATTN: PHARMACY	TEMPE	AZ	85282	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD AND DRUG	DBA FRY'S FOOD AND DRUG #114	9245 W. UNION HILLS	PEORIA	AZ	85382	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD AND DRUG CENTERS, INC.	DBA FRYS FOOD AND DRUG #78	39508 N DAISY MOUNTAIN DR	ANTHEM	AZ	85086	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD AND DRUG CTR	DBA FRY'S FOOD & DRUG #101	3232 S MILL AVENUE	TEMPE	AZ	85282	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITH'S FOOD DRUG CENTERS, INC	FRYS PHARMACY #672	20797 N JOHN WAYNE PKWY	MARICOPA	AZ	85139	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTER INC	DBA FRY'S FOOD AND DRUG #125	10450 NO 90TH STREET	SCOTTSDALE	AZ	85258	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #48	1385 E FLORENCE BLVD.	CASA GRANDE	AZ	85122	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #6	5771 W THUNDERBIRD	GLENDALE	AZ	85306	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #618	3246 E. BELL ROAD	PHOENIX	AZ	85032	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD AND DRUG #67	4815 E CAREFREE HIGHWAY STE 100	CAVE CREEK	AZ	85331	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #64	714 S VAL VISTA DRIVE	GILBERT	AZ	85296	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #43	2700 W BASELINE	TEMPE	AZ	85283	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD AND DRUG # 668	985 E RIGGS ROAD	CHANDLER	AZ	85249	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #56	9043 W OLIVE	PEORIA	AZ	85345	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #625	6611 W. BELL ROAD	GLENDALE	AZ	85308	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #66	10675 W INDIAN SCHOOL ROAD	AVONDALE	AZ	85392	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #26	5116 W OLIVE	GLENDALE	AZ	85302	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #22	1835 E GUADALUPE	TEMPE	AZ	85283	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #611	4440 E. MAIN STREET	MESA	AZ	85205	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRY'S FOOD & DRUG 609	850 E. HATCHER ROAD	PHOENIX	AZ	85020	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG 628	3949 E. CHANDLER BLVD	PHOENIX	AZ	85044	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #52	855 W WARNER ROAD	GILBERT	AZ	85233	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #73	6625 W. HAPPY VALLEY ROAD	GLENDALE	AZ	85310	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #54	4842 E BELL ROAD	SCOTTSDALE	AZ	85254	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #28	4315 W BELL ROAD	GLENDALE	AZ	85308	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #623	1815 W. GLENDALE AVENUE	PHOENIX	AZ	85021	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #60	20220 N 59 AVENUE	GLENDALE	AZ	85308	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS	DBA FRYS FOOD & DRUG #621	8900 E. VIA LINDA	SCOTTSDALE	AZ	85258	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CENTERS, INC.	DBA FRYS FOOD #673	20427 N. HAYDEN ROAD	SCOTSDALE	AZ	85255	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CTRS	DBA FRY'S FOOD AND DRUG #120	6321 EAST GREENWAY	SCOTTSDALE	AZ	85254	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CTRS	DBA FRY'S FOOD AND DRUG #121	4025 E THUNDERBIRD RD	PHOENIX	AZ	85032	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD & DRUG CTRS	DBA FRY'S FOOD AND DRUG #70	14845 E. SHEA BLVD.	FOUNTAIN HILLS	AZ	85268	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD AND DRUG CENTERS	DBA FRYS FOOD STORES #474	29455 N. CAVE CREEK ROAD	CAVE CREEK	AZ	85331	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	SMITHS FOOD AND DRUG CENTERS	DBA FRYS FOOD & DRUG #81	2250 E BASELINE RD	PHOENIX	AZ	85040	07/17/2019	10/01/2019	03/08/2021	03/22/2021
Contract Detail	SMITHS FOOD AND DRUG CENTERS INC	DBA FRYS FOOD STORES OF AZ #669	2858 N PINAL AVE	CASA GRANDE	AZ	85122	07/17/2019	10/01/2019	10/26/2020	10/26/2020
Contract Detail	ST JOSEPH'S MCAULEY PHARMACY	500 W. THOMAS ROAD	SUITE 190	PHOENIX	AZ	85013	07/13/2023	10/01/2023		10/01/2023
Contract Detail	WAL-MART PHARMACY 10-2113	1607 WEST BETHANY HOME RD		PHOENIX	AZ	85015	10/09/2019	01/01/2020	10/12/2020	02/08/2021
Contract Detail	WAL-MART PHARMACY 10-2515	3721 EAST THOMAS ROAD		PHOENIX (EAST)	AZ	85018	10/09/2019	01/01/2020	10/12/2020	02/08/2021
Contract Detail	WAL-MART PHARMACY 10-5315	2354 COMMERCE PARK DR.		ORLANDO	FL	32819	10/09/2019	01/01/2020	12/31/2020	02/08/2021
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/09/2019	01/01/2020	12/31/2020	02/08/2021
Contract Detail	WALGREEN ARIZONA DRUG CO	DBA: WALGREENS #10111	3434 W. SOUTHERN AVE	PHOENIX	AZ	85041	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO	WALGREENS SPECIALTY PHARMACY #21213	5149 W THUNDERBIRD RD.	GLENDALE	AZ	85306	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO	DBA: WALGREENS #09472	2707 W CAREFREE HWY	PHOENIX	AZ	85085-8843	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 01272	5101 WEST INDIAN SCHOOL	PHOENIX	AZ	85031	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02851	7000 N 16TH ST	PHOENIX	AZ	85020	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03177	7011 E. SHEA BLVD.	SCOTTSDALE	AZ	85254	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03003	6690 W. UNION HILLS	GLENDALE	AZ	85308	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03191	10865 NORTH TATUM BLVD.	PHOENIX	AZ	85028	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03464	3402 N CENTRAL AVE	PHOENIX	AZ	85012	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03657	3361 NORTH LITCHFIELD RD	GOODYEAR	AZ	85395	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03769	1616 E. THOMAS	PHOENIX	AZ	85016	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07663	8280 W LOWER BUCKEYE ROAD	PHOENIX	AZ	85043	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07375	1840 W SOUTHERN AVE	PHOENIX	AZ	85041-4631	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07018	6838 N 7TH STREET	PHOENIX	AZ	85014-1014	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06697	7606 S 7TH ST	PHOENIX	AZ	85042	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06535	2420 E BASELINE ROAD	PHOENIX	AZ	85042	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03789	3605 E THOMAS RD	PHOENIX	AZ	85018	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04046	3960 E CHANDLER BLVD	PHOENIX	AZ	85048	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04139	3450 W. DUNLAP AVE	PHOENIX	AZ	85051	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04722	4111 N 24TH STREET	PHOENIX	AZ	85016	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05504	4249 W GLENDALE AVE	PHOENIX	AZ	85051	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05505	3502 W CAMELBACK RD	PHOENIX	AZ	85019	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05893	705 EAST MCDOWELL RD	PHOENIX	AZ	85006	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05937	4315 W MCDOWELL RD	PHOENIX	AZ	85035	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05938	4134 N 44TH ST	PHOENIX	AZ	85018	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06021	1620 N 59TH AVE	PHOENIX	AZ	85035	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06063	1825 W BETHANY HOME RD	PHOENIX	AZ	85015-2512	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06065	9009 N 67TH AVE	GLENDALE	AZ	85302	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06527	710 E CAMELBACK ROAD	PHOENIX	AZ	85014	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03657	3361 NORTH LITCHFIELD RD	GOODYEAR	AZ	85395	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02599	7337 N VIA PASEO DEL SUR	SCOTTSDALE	AZ	85258	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02243	387 N ESTRELLA PKWY	GOODYEAR	AZ	85338	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03003	6690 W. UNION HILLS	GLENDALE	AZ	85308	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07375	1840 W SOUTHERN AVE	PHOENIX	AZ	85041-4631	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05505	3502 W CAMELBACK RD	PHOENIX	AZ	85019	10/08/2019	01/01/2020	09/30/2020	10/26/2020
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06063	1825 W BETHANY HOME RD	PHOENIX	AZ	85015-2512	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02851	7000 N 16TH ST	PHOENIX	AZ	85020	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 00809	8911 N 7TH ST	PHOENIX	AZ	85020	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04139	3450 W. DUNLAP AVE	PHOENIX	AZ	85051	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07018	6838 N 7TH STREET	PHOENIX	AZ	85014-1014	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 01969	6006 N 67TH AVE	GLENDALE	AZ	85301	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05504	4249 W GLENDALE AVE	PHOENIX	AZ	85051	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 01197	1745 E SOUTHERN AVE	TEMPE	AZ	85282-7625	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06065	9009 N 67TH AVE	GLENDALE	AZ	85302	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03191	10865 NORTH TATUM BLVD.	PHOENIX	AZ	85028	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 01272	5101 WEST INDIAN SCHOOL	PHOENIX	AZ	85031	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03464	3402 N CENTRAL AVE	PHOENIX	AZ	85012	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03789	3605 E THOMAS RD	PHOENIX	AZ	85018	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06527	710 E CAMELBACK ROAD	PHOENIX	AZ	85014	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03769	1616 E. THOMAS	PHOENIX	AZ	85016	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04046	3960 E CHANDLER BLVD	PHOENIX	AZ	85048	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05937	4315 W MCDOWELL RD	PHOENIX	AZ	85035	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05938	4134 N 44TH ST	PHOENIX	AZ	85018	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04722	4111 N 24TH STREET	PHOENIX	AZ	85016	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06021	1620 N 59TH AVE	PHOENIX	AZ	85035	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05893	705 EAST MCDOWELL RD	PHOENIX	AZ	85006	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03177	7011 E. SHEA BLVD.	SCOTTSDALE	AZ	85254	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06697	7606 S 7TH ST	PHOENIX	AZ	85042	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03008	785 S. COOPER ROAD	GILBERT	AZ	85233	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03728	7059 E. BASELINE RD.	MESA	AZ	85209	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03087	5625 E THOMAS RD	PHOENIX	AZ	85018	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03387	10705 W INDIAN SCHOOL	AVONDALE	AZ	85392	10/08/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA WALGREENS #13758	6200 N. SCOTTSDALE RD.	SCOTTSDALE	AZ	85253	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06533	100 S BEELINE HWY	PAYSON	AZ	85541-4809	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05090	5160 S WHITE MOUNTAIN RD	SHOW LOW	AZ	85901	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05222	9040 W. PEORIA AVE.	PEORIA	AZ	85345	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 11610	2000 S. MILL AVE.	TEMPE	AZ	85282	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04228	5125 W. NORTHERN AVE.	GLENDALE	AZ	85301	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06535	2420 E BASELINE ROAD	PHOENIX	AZ	85042	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03477	204 E BELL RD	PHOENIX	AZ	85022	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 02771	1305 S GREENFIELD RD	MESA	AZ	85206	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03670	1159 E. SOUTHERN AVE.	MESA	AZ	85204	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06534	20631 NORTH SCOTTSDALE RD	SCOTTSDALE	AZ	85255	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03912	29660 N TATUM BLVD	CAVE CREEK	AZ	85331	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 13870	4875 E ELLIOT RD.	PHOENIX	AZ	85044	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03049	4965 W BELL ROAD	GLENDALE	AZ	85308	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04742	8310 W DEER VALLEY RD.	PEORIA	AZ	85382	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03215	1935 NORTH POWER RD.	MESA	AZ	85205	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07663	8280 W LOWER BUCKEYE ROAD	PHOENIX	AZ	85043	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03766	34402 N. SCOTTSDALE ROAD	SCOTTSDALE	AZ	85266	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03163	3420 N. SCOTTSDALE RD	SCOTTSDALE	AZ	85251	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #11470	25073 W SOUTHERN AVE	BUCKEYE	AZ	85326	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06177	1135 N MESA DRIVE	MESA	AZ	85201	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06872	2930 N 67TH AVE	PHOENIX	AZ	85033	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 16082	10602 N. 32ND STREET	PHOENIX	AZ	85028	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05215	2363 S LINDSAY RD	GILBERT	AZ	85295	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #11181	5975 W. RAY RD	CHANDLER	AZ	85226-1827	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03593	2610 WEST THUNDERBIRD RD.	PHOENIX	AZ	85023	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03727	1919 N DOBSON RD	CHANDLER	AZ	85224	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04793	1975 S ALMA SCHOOL RD	CHANDLER	AZ	85286	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03385	5421 W THUNDERBIRD RD	GLENDALE	AZ	85306	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06692	4766 E QUEEN CREEK RD	GILBERT	AZ	85297-8005	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03669	10324 E RIGGS RD	SUN LAKES	AZ	85248	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04422	3945 E SOUTHERN AVE	PHOENIX	AZ	85040	10/09/2019	01/01/2020	11/30/2018	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03427	7448 W THUNDERBIRD RD	PEORIA	AZ	85381	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	WALGREENS SPECIALTY PHARMACY #16431	2302 N. CENTRAL AVE. SUITE 7	PHOENIX	AZ	85004	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS DRUG # 04020	5895 W. PEORIA AVENUE	GLENDALE	AZ	85302	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03531	4949 WEST CHANDLER BLVD	CHANDLER	AZ	85226	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06400	8030 N 19TH AVE	PHOENIX	AZ	85021-5101	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06666	2880 N CENTRE COURT	PRESCOTT VALLEY	AZ	86314	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #12739	15450 N TATUM BLVD	PHOENIX	AZ	85032	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04188	55 W. APACHE TRAIL	APACHE JUNCTION	AZ	85120	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04507	15025 N THOMPSON PEAK PKWY	SCOTTSDALE	AZ	85260	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS #09571	1020 N HIGHWAY 89	CHINO VALLEY	AZ	86323	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07387	10710 WEST MCDOWELL ROAD	AVONDALE	AZ	85392	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09264	21274 N JOHN WAYNE PKWY	MARICOPA	AZ	85139	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05668	8301 W CAMELBACK	PHOENIX	AZ	85037	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07516	2411 W ANTHEM WAY	ANTHEM	AZ	85086	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04376	1825 E. WARNER ROAD	TEMPE	AZ	85284	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 03132	2415 E. UNION HILLS DRIVE	PHOENIX	AZ	85050-3146	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06428	15385 N DYSART ROAD	EL MIRAGE	AZ	85335	10/09/2019	01/01/2020	03/02/2020	02/08/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04909	2921 N. 83RD AVE.	PHOENIX	AZ	85033	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06599	13227 N 7TH STREET	PHOENIX	AZ	85022-5303	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06736	4410 W CACTUS ROAD	GLENDALE	AZ	85304-2332	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06060	16415 PALISADES BLVD E	FOUNTAIN HILLS	AZ	85268	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09175	23477 W YUMA RD	BUCKEYE	AZ	85326	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05208	25 LAKE HAVASU AVE S	LAKE HAVASU CITY	AZ	86403	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 04344	1514 E FLORENCE BLVD	CASA GRANDE	AZ	85122	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 06095	9045 W INDIAN SCHOOL RD	PHOENIX	AZ	85037	10/09/2019	01/01/2020	05/24/2021	07/19/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09179	5115 W BASELINE ROAD	LAVEEN	AZ	85339	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09057	18433 N 19TH AVENUE	PHOENIX	AZ	85023-1359	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 09261	4710 E ROSE GARDEN LANE	PHOENIX	AZ	85050	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07784	2650 W GLENDALE AVE	PHOENIX	AZ	85051-6716	10/09/2019	01/01/2020	02/07/2020	02/10/2020
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05776	1451 N DYSART ROAD	AVONDALE	AZ	85323	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07933	15514 W WADDELL RD	SURPRISE	AZ	85379	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 07828	6002 E MAIN STREET	MESA	AZ	85205	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	DBA: WALGREENS # 05775	8309 W GLENDALE AVE	GLENDALE	AZ	85305	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREEN ARIZONA DRUG CO.	WALGREENS CENTRAL FILL #21372	120 N 83RD AVE STE 200	TOLLESON	AZ	85353	07/19/2021	10/01/2021	11/30/2016	12/09/2021
Contract Detail	WALGREEN CO.	WALGREENS #15929	201 CEDAR SE, SUITE 102	ALBUQUERQUE	NM	87106	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	10/25/2013	01/01/2014	12/15/2016	01/04/2017
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	10/09/2019	01/01/2020	11/30/2021	12/09/2021
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	10/14/2019	01/01/2020	11/30/2021	12/09/2021

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH030024C	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	Trauma Clinic	500 West Thomas Rd	Phoenix	AZ	Terminated
DSH030024D	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	Dignity Health Cancer Institute at St Joseph	625 N. 6th Street	PHOENIX	AZ	Active
DSH030024E	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	Neuro Muscular Outpatient Infusion Services	240 West Thomas Road	Phoenix	AZ	Terminated
DSH030024F	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	OP Infusion	500 West Thomas Road	Phoenix	AZ	Active
DSH030024G	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	Oncology Clinic - Gynecologic - Oncology Clinic - Gynecologic	500 W. Thomas Rd.	Phoenix	AZ	Terminated
DSH030024H	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	Cancer/Oncology Clinic 3 - Cancer/Oncology Clinic 3	500 W Thomas Rd	Phoenix	AZ	Terminated
DSH030024J	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	Liver Disease and Transplantation - Liver Disease and Transplantation	500 W Thomas Rd	Phoenix	AZ	Terminated
DSH030024K	Child	DSH	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	Rehab Neuro - Rehab Neuro	222 W Thomas Rd	Phoenix	AZ	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	8/17/2023 10:08:20 AM	8/18/2024 9:34:58 AM	8/18/2024 9:34 AM
Contacts	Primary Contact	Update	Profile Change Request	Schultz, Mitchell RPh, 340b Division Manager CommonSpirit Health - Midwest Division 7019280620	Schultz, Mitchell RPh, 340b Regional Manager CommonSpirit Health - Central Region 7019280620	8/6/2024 1:57 PM
Contacts	Primary Contact	Update	Group Change Request	Pearcy, Ryan 340B Division Manager CommonSpirit Health 8592295654	Schultz, Mitchell RPh, 340b Division Manager CommonSpirit Health - Midwest Division 7019280620	7/10/2024 3:31 PM
Details	Last Recertification Date	Update	Recertification	9/8/2022 7:34:27 AM	8/17/2023 10:08:20 AM	8/17/2023 10:08 AM
Addresses	Shipping Address	Delete	Change Request	St. Joseph's McAuley Pharmacy 500 W. Thomas Rd Suite 190 Phoenix, AZ 85013		7/13/2023 1:15 PM
Addresses	Shipping Address	Delete	Change Request	UA Cancer Center Dignity Health St. Joseph's Outpatient Pharmacy 625 N. 6th Street Phoenix, AZ 85004		5/10/2023 8:22 AM
Details	Last Recertification Date	Update	Recertification	8/23/2021 9:46:30 AM	9/8/2022 7:34:27 AM	9/8/2022 7:34 AM
Contacts	Primary Contact	Update	Change Request	Mesdaghi, Mike Senior Director of Pharmacy Dignity Health 6024064744	Pearcy, Ryan 340B Division Manager CommonSpirit Health 8592295654	1/31/2022 10:28 AM
Details	Last Recertification Date	Update	Recertification	8/28/2020 9:34:42 AM	8/23/2021 9:46:30 AM	8/23/2021 9:46 AM
Contacts	Authorizing Official	Update	Profile Change Request	Jackson, Jeffrey VP Finance St.Joseph's Hospital and Medical Center 6024064618	Jackson, Jeffrey Chief Financial Officer St.Joseph's Hospital and Medical Center 6024064618	3/23/2021 8:08 AM
Contacts	Primary Contact	Update	Profile Change Request	Mesdaghi, Pooyan Senior Director of Pharmacy Dignity Health 6024064744	Mesdaghi, Mike Senior Director of Pharmacy Dignity Health 6024064744	3/22/2021 7:10 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1326084872 (AZ)		12/11/2020 5:24 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1952775298 (AZ)		12/11/2020 5:24 PM
Contacts	Primary Contact	Update	Change Request	Blank, Greg Director of Pharmacy St. Joseph's Hospital and Medical Center 6024064744	Mesdaghi, Pooyan Senior Director of Pharmacy Dignity Health 6024064744	9/9/2020 12:04 PM
Medicaid Billing	NPI: State	Update	Recertification		AZ	8/28/2020 9:34 AM
Medicaid Billing	NPI: State	Update	Recertification		AZ	8/28/2020 9:34 AM
Medicaid Billing	NPI: State	Update	Recertification		AZ	8/28/2020 9:34 AM
Details	Last Recertification Date	Update	Recertification	8/26/2019 10:42:14 AM	8/28/2020 9:34:42 AM	8/28/2020 9:34 AM
Details	Last Recertification Date	Update	Recertification	8/31/2018 11:17:25 AM	8/26/2019 10:42:14 AM	8/26/2019 10:42 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1952775298	10/11/2018 5:43 PM
Addresses	Shipping Address	Insert	Change Request		UA Cancer Center Dignity Health St. Joseph's Outpatient Pharmacy 625 N. 6th Street Phoenix, AZ 85004	9/20/2018 7:25 AM
Details	Last Recertification Date	Update	Recertification	11/9/2017 7:20:03 AM	8/31/2018 11:17:25 AM	8/31/2018 11:17 AM
Addresses	Billing Address	Insert	Change Request		Dignity Health Accounts Payable 3033 N. 3rd Avenue Phoenix, AZ 85013	6/15/2018 11:36 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1326084872	6/15/2018 11:36 AM
Addresses	Shipping Address	Insert	Change Request		St. Joseph's Hospital and Medical Center 350 W. Thomas Rd Phoenix, AZ 85013	3/30/2018 9:54 AM
Addresses	Shipping Address	Insert	Change Request		St. Joseph's McAuley Pharmacy 500 W. Thomas Rd Suite 190 Phoenix, AZ 85013	3/30/2018 9:54 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/12/2017 8:51 AM
Medicaid Billing	Medicaid: Number	Insert	Change Request		691974	12/12/2017 8:51 AM
Medicaid Billing	Medicaid: State	Insert	Change Request		AZ	12/12/2017 8:51 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1982733655	12/12/2017 8:51 AM
Details	Last Recertification Date	Update	Recertification	8/17/2016 12:00:00 AM	11/9/2017 7:20:03 AM	11/9/2017 7:20 AM
Contacts	Authorizing Official	Update		Jackson, Jeffrey VP Finance 6024064618	Jackson, Jeffrey VP Finance St.Joseph's Hospital and Medical Center 6024064618	10/20/2017 11:25 AM
Contacts	Primary Contact	Update		Blank, Greg Director of Pharmacy 6024064744	Blank, Greg Director of Pharmacy St. Joseph's Hospital and Medical Center 6024064744	10/4/2017 2:49 PM
Contacts	Primary Contact	Update		Eslinger, Christian Pharmacy Manager 6024066480	Blank, Greg Director of Pharmacy 6024064744	7/17/2017 12:08 PM
Contacts	Authorizing Official	Update		Walker, Penny VP Ancillary Operations 6024064361	Jackson, Jeffrey VP Finance 6024064618	7/17/2017 12:08 PM
Addresses	Main Address	Insert			350 W THOMAS ROAD PHOENIX, AZ 85013	7/5/2017 11:15 AM
Contacts	Primary Contact	Update		Kaimal, Girish Pharmacy Manager 6024064152	Eslinger, Christian Pharmacy Manager 6024066480	5/9/2017 9:30 AM
Contacts	Primary Contact	Update		Grimm, Doneen Director of Pharmacy 6024064273	Kaimal, Girish Pharmacy Manager 6024064152	3/7/2017 8:59 AM
Contacts	Primary Contact	Update		Hynes, Phillip Director - Laboratory Services 6024066212	Grimm, Doneen Director of Pharmacy 6024064273	8/17/2016 7:18 AM
Details	Last Recertification Date	Update		8/26/2015 12:00:00 AM	8/17/2016 12:00:00 AM	8/17/2016 7:18 AM
Details	Last Recertification Date	Update		9/8/2014 12:00:00 AM	8/26/2015 12:00:00 AM	8/26/2015 12:15 PM
Contacts	Primary Contact	Update		BONICELLI, DEBORAH L. DIRECTOR OF FINANCE 6024064467	Hynes, Phillip Director - Laboratory Services 6024066212	9/8/2014 1:30 PM
Details	Last Recertification Date	Update		9/6/2013 12:00:00 AM	9/8/2014 12:00:00 AM	9/8/2014 1:30 PM
Details	Last Recertification Date	Update		9/6/2013 12:14:01 PM	9/6/2013 12:00:00 AM	2/21/2014 2:56 PM
Details	Last Recertification Date	Update		1/1/2013 12:00:00 AM	9/6/2013 12:14:01 PM	9/6/2013 12:14 PM
Contacts	Authorizing Official	Update		BONICELLI, DEBORAH L. DIRECTOR OF FINANCE 6024064467	Walker, Penny VP Ancillary Operations 6024064361	12/20/2012 4:12 PM
Details	Last Recertification Date	Update			1/1/2013 12:00:00 AM	12/20/2012 6:51 AM
Dates	Participating Approval Date	Update		8/23/2007 8:18:04 AM	8/23/2007 12:00:00 AM	3/8/2012 2:20 PM
Details	Comments Public	Insert			3/8/12 update zipcode last digit from 4 to 3 and add new shipping addresses	3/8/2012 2:20 PM
Contacts	Authorizing Official	Insert			BONICELLI, DEBORAH L. DIRECTOR OF FINANCE 6024064467	9/28/2007 1:56 PM
Contacts	Primary Contact	Insert			BONICELLI, DEBORAH L. DIRECTOR OF FINANCE 6024064467	9/28/2007 1:56 PM
Details	Last Recertification Date	Insert				8/23/2007 8:09 AM
Details	Grant Number	Insert				8/23/2007 8:09 AM
Details	340B ID	Insert			DSH030024	8/23/2007 8:09 AM
Details	Is Authorizing Official EHB Data	Insert				8/23/2007 8:09 AM
Dates	Last Date That 340B Drugs Purchased	Insert				8/23/2007 8:09 AM
Details	Medicare Provider Number	Insert			030024	8/23/2007 8:09 AM
Details	Entity Name	Insert			ST JOSEPH'S HOSPITAL AND MEDICAL CENTER	8/23/2007 8:09 AM
Details	Program Code	Insert			DSH	8/23/2007 8:09 AM
Details	Entity Subname	Insert				8/23/2007 8:09 AM
Dates	Participating Approval Date	Insert			8/23/2007 8:18:04 AM	8/23/2007 8:09 AM
Details	State	Insert			Active	8/23/2007 8:09 AM
Dates	Registration Date	Insert			8/23/2007 12:00:00 AM	8/23/2007 8:09 AM
Dates	Signed By Date	Insert				8/23/2007 8:09 AM
Dates	Start Date	Insert			1/1/2005 12:00:00 AM	8/23/2007 8:09 AM
Terminations	Termination Comments	Insert				8/23/2007 8:09 AM
Terminations	Termination Date	Insert				8/23/2007 8:09 AM
Terminations	Termination Effective Date	Insert				8/23/2007 8:09 AM
Terminations	Termination Reason	Insert				8/23/2007 8:09 AM