340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH160104 TRINITY BETTENDORF
Print
Covered Entity Details
Entity Name
TRINITY BETTENDORF
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH160104
Entity Address
4500 UTICA RIDGE ROAD
BETTENDORF, IA 52722
Medicare Provider Number
160104
Participating Start Date
4/1/2017
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03595
1720 W. KIMBERLY RD.
DAVENPORT, IA 52806
Pharmacy Comments
Contract Details
Approval Date
10/7/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dave Dellitt, Chief Financial Officer
(309) 779-2218
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/7/2019
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