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WALGREEN CO.
RRC140281-00 NORTHWESTERN MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
NORTHWESTERN MEMORIAL HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140281-00
Entity Address
251 E HURON
CHICAGO, IL 60611
Medicare Provider Number
140281
Participating Start Date
8/7/2020
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15196
151 N. STATE ST.
CHICAGO, IL 60601-3601
Pharmacy Comments
Contract Details
Approval Date
1/10/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matthew Joseph Flynn, VP, Finance, NMHC
(312) 926-5236
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/10/2023
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