340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH140127 ADVOCATE BROMENN MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ADVOCATE BROMENN MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140127
Entity Address
1304 FRANKLIN AVENUE
NORMAL, IL 61761
Medicare Provider Number
140127
Participating Start Date
1/1/2019
Last Recertification Date
Entity Termination Date
7/1/2019
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15283
101 W UNIVERSITY AVE STE 102
CHAMPAIGN, IL 61820
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/30/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Aron Klein, VP Finance
(309) 268-2410
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2019
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