Contract Pharmacy Details

BOND DRUG COMPANY OF ILLINOIS, L.L.C.
SCH140189-00 SARAH BUSH LINCOLN HEALTH CENTER

Covered Entity Details

Entity Name

SARAH BUSH LINCOLN HEALTH CENTER

Subdivision Name

Type

Sole Community Hospital

340B ID

SCH140189-00

Entity Address

1000 HEALTH CENTER DRIVE
MATTOON, IL 61938

Medicare Provider Number

140189

Participating Start Date

7/1/2018

Last Recertification Date

9/4/2024

Entity Termination Date

4/1/2025

Pharmacy Details

Pharmacy Name

BOND DRUG COMPANY OF ILLINOIS, L.L.C.

Pharmacy Address

DBA: WALGREENS # 05444
212 S LOGAN AVE
MATTOON, IL 61938

Pharmacy Comments

Contract Details

Approval Date

1/13/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Jerry Esker, President & CEO
(217) 258-2540

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/13/2020

340B Drug Pricing Program Database