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BOND DRUG COMPANY OF ILLINOIS, L.L.C.
SCH140089-00 MCDONOUGH DISTRICT HOSPITAL
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Covered Entity Details
Entity Name
MCDONOUGH DISTRICT HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH140089-00
Entity Address
525 E. GRANT
MACOMB, IL 61455
Medicare Provider Number
140089
Participating Start Date
7/1/2017
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
Pharmacy Address
DBA: WALGREENS # 04504
844 W FREMONT ST
GALESBURG, IL 61401
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William R Murdock, President & CEO
(309) 833-4101 Ext: 13499
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2020
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