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WALGREEN CO.
SCH270017-00 SAINT JAMES HEALTHCARE
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Covered Entity Details
Entity Name
SAINT JAMES HEALTHCARE
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH270017-00
Entity Address
400 SOUTH CLARK
BUTTE, MT 59701
Medicare Provider Number
270017
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #13818
2611 HARRISON AVE.
BUTTE, MT 59701
Pharmacy Comments
Contract Details
Approval Date
7/16/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/11/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Pam Palagi, VP of Finacial Services
(406) 723-2414
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/16/2019
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