Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
DSH450046 CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE

Covered Entity Details

Entity Name

CHRISTUS SPOHN HOSPITAL CORPUS CHRISTI SHORELINE

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH450046

Entity Address

600 Elizabeth St.
CORPUS CHRISTI, TX 78404

Medicare Provider Number

450046

Participating Start Date

4/1/1997

Last Recertification Date

8/19/2024

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

7/14/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/15/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Becky Rios, Interim CFO
(361) 881-3157

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