340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH140182 ADVOCATE NORTH SIDE HEALTH NETWORK
Print
Covered Entity Details
Entity Name
ADVOCATE NORTH SIDE HEALTH NETWORK
Subdivision Name
DBA ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (AIMMC)
Type
Disproportionate Share Hospital
340B ID
DSH140182
Entity Address
836 West Wellington Ave.
CHICAGO, IL 60657
Medicare Provider Number
140182
Participating Start Date
10/27/2005
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS 16299
331 W. SURF ST.
SUITE 101
CHICAGO, IL 60657-7160
Pharmacy Comments
Contract Details
Approval Date
1/20/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JACK GILBERT, VP FINANCE
(773) 296-7809
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/20/2016
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