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WALGREENS SPECIALTY PHARMACY, LLC
CAH271335-00 Community Hospital of Anaconda
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Covered Entity Details
Entity Name
Community Hospital of Anaconda
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH271335-00
Entity Address
401 West Pennsylvania Street
Anaconda, MT 59711
Medicare Provider Number
271335
Participating Start Date
1/1/2013
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
10/10/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Margaret Irene Hickey-Boynton, CFO
(406) 563-8512
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/10/2021
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