Contract Pharmacy Details

WALGREEN CO.
RRC520030-00 ASPIRUS WAUSAU HOSPITAL

Covered Entity Details

Entity Name

ASPIRUS WAUSAU HOSPITAL

Subdivision Name

Type

Rural Referral Center

340B ID

RRC520030-00

Entity Address

333 PINE RIDGE BOULEVARD
WAUSAU, WI 54401

Medicare Provider Number

520030

Participating Start Date

12/21/2022

Last Recertification Date

8/19/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06935
10 PARK RIDGE DRIVE
STEVENS POINT, WI 54481-4344

Pharmacy Comments

Contract Details

Approval Date

1/3/2023

Contract Begin Date

1/11/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

PAT TINCHER, Vice President-Finance, Regional Markets
(715) 847-2425

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/3/2023

340B Drug Pricing Program Database