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Walgreens #21389
CAH141324-00 Ferrell Hospital Community Foundation dba Ferrell Hospital
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Covered Entity Details
Entity Name
Ferrell Hospital Community Foundation dba Ferrell Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141324-00
Entity Address
1201 Pine Street
Eldorado, IL 62930
Medicare Provider Number
141324
Participating Start Date
4/1/2012
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
Walgreens #21389
Pharmacy Address
Walgreens Central Fill #21389
3299 Tchulatech Dr
Suite 101
Memphis, TN 38118
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
Angela Marie Craig, Controller
(618) 273-3361 Ext: 157
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/18/2022
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