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WALGREEN CO.
CAH251318-00 NORTH SUNFLOWER MEDICAL CENTER
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Covered Entity Details
Entity Name
NORTH SUNFLOWER MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH251318-00
Entity Address
840 NORTH OAK AVENUE
RULEVILLE, MS 38771
Medicare Provider Number
251318
Participating Start Date
9/16/2010
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11171
700 W PARK AVE
GREENWOOD, MS 38930-2910
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sam Miller, Chief Executive Officer
(662) 721-0186
Contract Pharmacy Representative
Walgreens
Chris Sutter, Account Manager, Health Systems
(847) 612-0296
Signed By Date
4/15/2021
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