340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREENS SPECIALTY PHARMACY, LLC
DSH220074 SOUTHCOAST HOSPITALS GROUP, INC
Print
Covered Entity Details
Entity Name
SOUTHCOAST HOSPITALS GROUP, INC
Subdivision Name
DBA CHARLTON MEMORIAL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH220074
Entity Address
363 HIGHLAND AVENUE
FALL RIVER, MA 02720
Medicare Provider Number
220074
Participating Start Date
7/1/2004
Last Recertification Date
8/28/2024
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
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Renee Clark, Exec. Vice President & Chief Operating Officer
(508) 973-5872
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2020
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