340B Drug Pricing Program Database

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Effective Sunday, September 1, OPA is implementing a change to the export format for Medicaid and NPI numbers. This change affects covered entity exports that include Medicaid and/or NPI billing numbers, and the CE Daily Report in Excel format. If the number is associated with more than one state, all the states will be listed between one set of parentheses following the number - for example, 1275575227 (IN,MI,OH). This change is necessary to ensure that the exported data does not exceed Excel’s limit for field length.

PRIME THERAPEUTICS SPECIALTY PHARMACY LL
CAH031318-00 BANNER PAYSON MEDICAL CENTER

Covered Entity Details

Critical Access Hospital
CAH031318-00
807 S. PONDEROSA
PAYSON, AZ 85541
031318
1/1/2020
8/20/2024


Pharmacy Details

ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992

Contract Details

1/9/2020
4/1/2020

11/9/2022
Business decision by covered entity and/or pharmacy


Contacts


Matthew K King, Senior Finance Director
(801) 682-9661



Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
1/9/2020