340B Drug Pricing Program Database
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WALGREEN CO.
CAH151319-00 Gibson General Hospital, Inc
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Covered Entity Details
Entity Name
Gibson General Hospital, Inc
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151319-00
Entity Address
1808 Sherman Drive
Princeton, IN 47670
Medicare Provider Number
151319
Participating Start Date
1/1/2012
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11882
1915 W BROADWAY STREET
PRINCETON, IN 47670
Pharmacy Comments
Contract Details
Approval Date
10/1/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lois Morgan, VP/Chief Nursing Officer
(812) 385-9237
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/1/2018
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