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WALGREEN CO.
DSH420036 MUSC Health Lancaster Medical Center
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Covered Entity Details
Entity Name
MUSC Health Lancaster Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH420036
Entity Address
800 WEST MEETING STREET
LANCASTER, SC 29720
Medicare Provider Number
420036
Participating Start Date
1/1/2020
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 10448
1101 HIGHWAY 9 BYP W
LANCASTER, SC 29720-1710
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Goodlett, Chief Financial Officer
(843) 792-4775
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2020
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