Contract Pharmacy Details

WALGREEN CO.
CAH141337-00 OSF Saint Clare Medical Center

Covered Entity Details

Entity Name

OSF Saint Clare Medical Center

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH141337-00

Entity Address

530 Park Ave East
Princeton, IL 61356

Medicare Provider Number

141337

Participating Start Date

1/1/2013

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06554
1033 SHOOTING PARK ROAD
PERU, IL 61354-1870

Pharmacy Comments

Contract Details

Approval Date

10/8/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Diane L. McGrew, President
(309) 655-2850

Contract Pharmacy Representative

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

Signed By Date

10/8/2021

340B Drug Pricing Program Database