Contract Pharmacy Details

WALGREEN CO.
CAH171384-00 NEWMAN MEMORIAL COUNTY HOSPITAL

Covered Entity Details

Entity Name

NEWMAN MEMORIAL COUNTY HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH171384-00

Entity Address

1201 W. 12th Ave.
EMPORIA, KS 66801

Medicare Provider Number

171384

Participating Start Date

1/1/2016

Last Recertification Date

8/23/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04782
3696 SW TOPEKA BLVD
TOPEKA, KS 66611

Pharmacy Comments

Contract Details

Approval Date

7/9/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Holly R. French, CFO
(620) 343-6800 Ext: 22610

Contract Pharmacy Representative

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

Signed By Date

7/9/2020

340B Drug Pricing Program Database