Contract Pharmacy Details

WALGREEN CO.
DSH440039 Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic

Covered Entity Details

Entity Name

Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH440039

Entity Address

1211 MEDICAL CENTER DRIVE
NASHVILLE, TN 37232

Medicare Provider Number

440039

Participating Start Date

7/1/2002

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #11600
601 SKYLINE DR.
JACKSON, TN 38301

Pharmacy Comments

Contract Details

Approval Date

10/9/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Cecelia Britt Moore, Chief Financial Officer
(615) 322-0084

Contract Pharmacy Representative

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

Signed By Date

10/9/2020

340B Drug Pricing Program Database