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WALGREEN CO.
SCH060071-00 DELTA COUNTY MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
DELTA COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH060071-00
Entity Address
1501 E. 3RD ST.
DELTA, CO 81416
Medicare Provider Number
060071
Participating Start Date
7/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #12805
499 E HAMPDEN AVE STE 150
ENGLEWOOD, CO 80113
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Matthew Heyn, CEO
(970) 874-2229
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/17/2023
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