340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN ARIZONA DRUG CO.
DSH030014 HONORHEALTH JOHN C. LINCOLN MED CTR
Print
Covered Entity Details
Entity Name
HONORHEALTH JOHN C. LINCOLN MED CTR
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH030014
Entity Address
250 E Dunlap Ave
Phoenix, AZ 85020
Medicare Provider Number
030014
Participating Start Date
7/1/2015
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
DBA: WALGREENS # 07375
1840 W SOUTHERN AVE
PHOENIX, AZ 85041-4631
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
2/20/2024
Pharmacy closed
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
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session