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WALGREEN CO.
DSH340091 THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
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Covered Entity Details
Entity Name
THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340091
Entity Address
1200 NORTH ELM STREET
GREENSBORO, NC 27401-1020
Medicare Provider Number
340091
Participating Start Date
4/1/2006
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #21438
6638 JORDAN RD
RAMSEUR, NC 27316
Pharmacy Comments
Contract Details
Approval Date
4/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andrew Barrow, Chief Financial Officer
(336) 832-7825
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/3/2023
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