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WALGREEN CO.
DSH500027 SWEDISH MEDICAL CENTER
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Covered Entity Details
Entity Name
SWEDISH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500027
Entity Address
747 BROADWAY
SEATTLE, WA 98122
Medicare Provider Number
500027
Participating Start Date
7/1/2006
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07132
11216 4TH AVENUE WEST
EVERETT, WA 98204-4979
Pharmacy Comments
Contract Details
Approval Date
10/19/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marybeth Formby, Chief Financial Officer
(206) 386-3033
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/19/2022
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