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WALGREEN CO
SCH230110-00 Corewell Health Ludington Hospital
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Covered Entity Details
Entity Name
Corewell Health Ludington Hospital
Subdivision Name
Ludington
Type
Sole Community Hospital
340B ID
SCH230110-00
Entity Address
1 N Atkinson Dr
Ludington, MI 49431
Medicare Provider Number
230110
Participating Start Date
1/1/2020
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #12533
819 W MAIN STREET
FREMONT, MI 49412
Pharmacy Comments
Contract Details
Approval Date
7/13/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Sella, Senior Director, Finance
(616) 643-9168
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/13/2021
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