Contract Pharmacy Details

WALGREEN CO.
CAH141309-00 CARLE EUREKA HOSPITAL

Covered Entity Details

Entity Name

CARLE EUREKA HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH141309-00

Entity Address

101 SOUTH MAJOR STREET
EUREKA, IL 61530

Medicare Provider Number

141309

Participating Start Date

1/1/2017

Last Recertification Date

8/21/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03763
1011 PEORIA ST
WASHINGTON, IL 61571-2487

Pharmacy Comments

Contract Details

Approval Date

4/14/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Dennis P. Hesch, Executive VP and CFO
(217) 326-8231

Contract Pharmacy Representative

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

Signed By Date

4/14/2021

340B Drug Pricing Program Database