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WALGREEN CO
CAH141334-00 SAINT JOSEPH MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
SAINT JOSEPH MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141334-00
Entity Address
2 SOUTH HOSPITAL DRIVE
MURPHYSBORO, IL 62966
Medicare Provider Number
141334
Participating Start Date
9/28/2010
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #12890
503 WALNUT STREET
MURPHYSBORO, IL 62966
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
REX BUDDE, CEO
(618) 457-5200
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2022
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