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WALGREEN CO.
DSH180040 UofL Health -- Louisville
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Covered Entity Details
Entity Name
UofL Health -- Louisville
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180040
Entity Address
200 ABRAHAM FLEXNER WAY
LOUISVILLE, KY 40202-1818
Medicare Provider Number
180040
Participating Start Date
12/6/2005
Last Recertification Date
8/31/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05449
3600 FERN VALLEY RD
LOUISVILLE, KY 40219
Pharmacy Comments
Contract Details
Approval Date
10/14/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steve Amsler, Senior Vice President of Operations
(502) 562-4122
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/14/2020
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