Contract Pharmacy Details

WALGREEN CO.
DSH240047 St. Luke's Hospital of Duluth

Covered Entity Details

Entity Name

St. Luke's Hospital of Duluth

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH240047

Entity Address

915 East First Street
Duluth, MN 55805

Medicare Provider Number

240047

Participating Start Date

10/1/2013

Last Recertification Date

8/30/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #15149
1609 KENWOOD AVENUE
DULUTH, MN 55811

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

Eric Lohn, Vice President/CFO
(218) 249-5475

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