340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
SCH140058-00 Jacksonville Memorial Hospital
Print
Covered Entity Details
Entity Name
Jacksonville Memorial Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH140058-00
Entity Address
1600 WEST WALNUT
JACKSONVILLE, IL 62650-1185
Medicare Provider Number
140058
Participating Start Date
10/1/2017
Last Recertification Date
9/15/2021
Entity Termination Date
7/7/2022
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #21190
1150 N 5TH ST
STE B
SPRINGFIELD, IL 62702
Pharmacy Comments
Contract Details
Approval Date
10/11/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/7/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
William Scott Boston, President & CEO
(217) 479-5523
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/11/2019
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