340B Drug Pricing Program Database

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #15051
251 COUNTY RD 120, SUITE #101
SAINT CLOUD, MN 56303

Pharmacy Comments

Approval Date

4/11/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/31/2024
Pharmacy closed

Covered Entity Signing Official

Lisa Bjerga, CHIEF FINANCIAL OFFICER
(218) 894-8352

Contract Pharmacy Representative

Lakewood Health System
BRIAN HINMAN, PHARMACY DIRECTOR
(218) 894-8458

Signed By Date

4/11/2019