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WALGREEN CO.
CAH161338-00 MercyOne Oelwein Medical Center
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Covered Entity Details
Entity Name
MercyOne Oelwein Medical Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH161338-00
Entity Address
201 8TH AVE
OELWEIN, IA 50662-2447
Medicare Provider Number
161338
Participating Start Date
9/30/2010
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #15322
826 N PLANKINTON AVE STE 100
MILWAUKEE, WI 53203
Pharmacy Comments
Formally Bioscrip Pharmacy
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/24/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
Timothy Huber, Vice President of Finance
(319) 272-7607
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2018
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