340B Drug Pricing Program Database
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WALGREEN CO.
RRC150128-00 COMMUNITY HOSPITAL SOUTH
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Covered Entity Details
Entity Name
COMMUNITY HOSPITAL SOUTH
Subdivision Name
Type
Rural Referral Center
340B ID
RRC150128-00
Entity Address
1402 EAST COUNTY LINE ROAD
INDIANAPOLIS, IN 46227
Medicare Provider Number
150128
Participating Start Date
1/1/2021
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04592
700 US HIGHWAY 31 S
GREENWOOD, IN 46143
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
David Kiley, President
(317) 621-9337
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2021
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