Contract Pharmacy Details

WALGREEN CO.
CAH231329-00 CARO COMMUNITY HOSPITAL

Covered Entity Details

Entity Name

CARO COMMUNITY HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH231329-00

Entity Address

401 N HOOPER ST
CARO, MI 48723

Medicare Provider Number

231329

Participating Start Date

4/21/2021

Last Recertification Date

8/26/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #21233
181 W HURON AVE
VASSAR, MI 48768-1235

Pharmacy Comments

Contract Details

Approval Date

4/18/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Danielle Christine Jacks-Porter, Chief Financial Officer
(989) 894-3838

Contract Pharmacy Representative

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

Signed By Date

4/18/2022

340B Drug Pricing Program Database