340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
CAH521346-00 ThedaCare Medical Center Shawano, Inc.
Print
Covered Entity Details
Entity Name
ThedaCare Medical Center Shawano, Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH521346-00
Entity Address
100 County Road B
Shawano, WI 54166
Medicare Provider Number
521346
Participating Start Date
4/1/2012
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12983
201 S. MAIN ST.
CLINTONVILLE, WI 54929
Pharmacy Comments
Contract Details
Approval Date
10/7/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Julie Chikowski, VP
(715) 526-7200
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/7/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session