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WALGREEN CO
CAH151331-00 HARRISON COUNTY HOSPITAL
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Covered Entity Details
Entity Name
HARRISON COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151331-00
Entity Address
1141 HOSPITAL DRIVE N.W
CORYDON, IN 47112
Medicare Provider Number
151331
Participating Start Date
8/4/2010
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10559
1716 HWY 337 NW
CORYDON, IN 47112-2028
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lisa Marie Lieber, Chief Administrative Officer
(812) 738-7884
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2022
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