340B Drug Pricing Program Database
WALGREEN CO.
RRC520066-00 MERCY HEALTH SYSTEM CORPORATION - information as of 5/13/2025 4:19:54 AM
Covered Entity Details
Entity Name
MERCY HEALTH SYSTEM CORPORATION
Subdivision Name
Type
Rural Referral Center
340B ID
RRC520066-00
Entity Address
1000 MINERAL POINT AVE
JANESVILLE, WI 53547-5003
Medicare Provider Number
520066
Participating Start Date
1/1/2024
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01159
104 N MAIN ST
VERONA, WI 53593
Pharmacy Comments
Contract Details
Approval Date
12/1/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Todd Anderson, Vice President Finance
(815) 971-6738
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2023
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