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WALGREENS SPECIALTY PHARMACY, LLC
RRC140043-00 CGH MEDICAL CENTER
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Covered Entity Details
Entity Name
CGH MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140043-00
Entity Address
100 EAST LEFEVRE ROAD
STERLING, IL 61081-1278
Medicare Provider Number
140043
Participating Start Date
1/1/2023
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
11/4/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ben Schaab, VP, CFO
(815) 625-0400
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/17/2022
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