Contract Pharmacy Details

WALGREEN CO.
DSH180040 UofL Health -- Louisville

Covered Entity Details

Entity Name

UofL Health -- Louisville

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH180040

Entity Address

200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202-1818

Medicare Provider Number

180040

Participating Start Date

12/6/2005

Last Recertification Date

8/31/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 07643
9801 BROWNSBORO RD.
LOUISVILLE, KY 40241-1125

Pharmacy Comments

Contract Details

Approval Date

4/10/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Steve Amsler, Senior Vice President of Operations
(502) 562-4122

Contract Pharmacy Representative

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

Signed By Date

4/10/2020

340B Drug Pricing Program Database