340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
CAH061327-00 Southwest Memorial Hospital
Print
Covered Entity Details
Entity Name
Southwest Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH061327-00
Entity Address
1311 North Mildred
Cortez, CO 81321
Medicare Provider Number
061327
Participating Start Date
4/1/2012
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #19273
28 TOWN PLAZA
DURANGO, CO 81301
Pharmacy Comments
Contract Details
Approval Date
1/7/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sam Radke, Interim CFO
(970) 564-2146
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/7/2019
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