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WALGREENS SPECIALTY PHARMACY, LLC
SCH010150-00 Regional Medical Center of Central Alabama
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Covered Entity Details
Entity Name
Regional Medical Center of Central Alabama
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH010150-00
Entity Address
29 LV STABLER DRIVE
GREENVILLE, AL 36037
Medicare Provider Number
010150
Participating Start Date
10/1/2019
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
10/11/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Glenn Wilcox, Chief Financial Officer
(334) 383-2423
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/11/2019
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