340B Drug Pricing Program Database
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WALGREEN CO.
DSH150113 COMMUNITY HOSPITAL ANDERSON
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Covered Entity Details
Entity Name
COMMUNITY HOSPITAL ANDERSON
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH150113
Entity Address
1515 NORTH MADISON AVE
ANDERSON, IN 46011
Medicare Provider Number
150113
Participating Start Date
4/1/2021
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06761
3736 S SCATTERFIELD RD
ANDERSON, IN 46013
Pharmacy Comments
Contract Details
Approval Date
4/7/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/12/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Beth Tharp, SVP/President of Hospital Services
(765) 298-5125
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/7/2022
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