340B Drug Pricing Program Database
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WALGREEN CO.
DSH440073 MAURY REGIONAL HOSPITAL
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Covered Entity Details
Entity Name
MAURY REGIONAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440073
Entity Address
1224 TROTWOOD AVENUE
COLUMBIA, TN 38401
Medicare Provider Number
440073
Participating Start Date
7/20/2022
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07659
1202 S JAMES CAMPBELL BLVD
COLUMBIA, TN 38401
Pharmacy Comments
Contract Details
Approval Date
12/20/2022
Contract Begin Date
12/20/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Martin Chaney, Chief Executive Officer
(931) 380-4008
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
12/20/2022
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