340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH260024 TEXAS COUNTY MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
TEXAS COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260024
Entity Address
1333 S SAM HOUSTON BLVD
HOUSTON, MO 65483
Medicare Provider Number
260024
Participating Start Date
4/1/2010
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
FORBES PHARMACY #15722, POWERED BY WALGR
100 NORTH GRAND
HOUSTON, MO 65483
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/29/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
LINDA PAMPERIEN, CFO
(417) 967-1255
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/13/2022
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