340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
CAH141319-00 Henry District Hospital
Print
Covered Entity Details
Entity Name
Henry District Hospital
Subdivision Name
Hammond Henry Hospital
Type
Critical Access Hospital
340B ID
CAH141319-00
Entity Address
600 North College Ave
Geneseo, IL 61254-1099
Medicare Provider Number
141319
Participating Start Date
10/1/2012
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #21190
1150 N 5TH ST
STE B
SPRINGFIELD, IL 62702
Pharmacy Comments
Contract Details
Approval Date
1/2/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laura J Domino, Vice President of Patient Care Services
(309) 944-9101
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/2/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session