Contract Pharmacy Details

WALGREEN CO.
DSH340091 THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION

Covered Entity Details

Entity Name

THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH340091

Entity Address

1200 NORTH ELM STREET
GREENSBORO, NC 27401-1020

Medicare Provider Number

340091

Participating Start Date

4/1/2006

Last Recertification Date

8/30/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 01253
340 N MAIN STREET
KERNERSVILLE, NC 27284-2881

Pharmacy Comments

Contract Details

Approval Date

7/14/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jeffrey Jones, Executive VP and CFO
(336) 832-8005

Contract Pharmacy Representative

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

Signed By Date

7/14/2020

340B Drug Pricing Program Database