Contract Pharmacy Details

BOND DRUG COMPANY OF ILLINOIS, L.L.C.
DSH140228 SWEDISH AMERICAN HOSPITAL

Covered Entity Details

Entity Name

SWEDISH AMERICAN HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH140228

Entity Address

1401 E STATE ST
ROCKFORD, IL 61104

Medicare Provider Number

140228

Participating Start Date

9/9/2005

Last Recertification Date

8/28/2024

Pharmacy Details

Pharmacy Name

BOND DRUG COMPANY OF ILLINOIS, L.L.C.

Pharmacy Address

DBA: WALGREENS # 04777
2525 S ALPINE ROAD
ROCKFORD, IL 61108

Pharmacy Comments

Contract Details

Approval Date

4/15/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

DON HARING, CFO
(815) 968-4400

Contract Pharmacy Representative

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

Signed By Date

4/15/2014

340B Drug Pricing Program Database