Contract Pharmacy Details

WALGREEN CO.
DSH260137 FREEMAN HEALTH SYSTEM

Covered Entity Details

Entity Name

FREEMAN HEALTH SYSTEM

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH260137

Entity Address

1102 WEST 32ND STREET
JOPLIN, MO 64804-3503

Medicare Provider Number

260137

Participating Start Date

4/1/2004

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09049
1911 N BROADWAY STREET
PITTSBURG, KS 66762-2811

Pharmacy Comments

Contract Details

Approval Date

4/5/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jeff Thompson, Chief Clinical Officer
(417) 347-3563

Contract Pharmacy Representative

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

Signed By Date

4/5/2022

340B Drug Pricing Program Database