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WALGREENS SPECIALTY PHARMACY, LLC
DSH340141 Novant Health New Hanover Regional Medical Center
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Covered Entity Details
Entity Name
Novant Health New Hanover Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340141
Entity Address
2131 South 17th Street
Attn: Pharmacy
Wilmington, NC 28401
Medicare Provider Number
340141
Participating Start Date
10/1/2003
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
5/22/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laurie Whalin, VP of Clinical Support Services
(910) 667-7731
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2020
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