Contract Pharmacy Details

WALGREEN ARIZONA DRUG CO.
RRC030038-00 HONORHEALTH SCOTTSDALE OSBORN MED CT

Covered Entity Details

Entity Name

HONORHEALTH SCOTTSDALE OSBORN MED CT

Subdivision Name

Type

Rural Referral Center

340B ID

RRC030038-00

Entity Address

7400 E Osborn Rd
Scottsdale, AZ 85251

Medicare Provider Number

030038

Participating Start Date

7/1/2019

Last Recertification Date

8/23/2023

Entity Termination Date

7/1/2024

Pharmacy Details

Pharmacy Name

WALGREEN ARIZONA DRUG CO.

Pharmacy Address

DBA: WALGREENS # 11182
1130 W. SOUTHERN AVE
MESA, AZ 85210

Pharmacy Comments

Contract Details

Approval Date

7/10/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Gary Baker, SVP-CEO-HOSPITAL
(480) 583-0803

Contract Pharmacy Representative

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

Signed By Date

7/10/2020

340B Drug Pricing Program Database