340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Walgreen CO
CAH141310-00 Mendota Community Hospital d/b/a OSF Saint Paul Medical Center
Print
Covered Entity Details
Entity Name
Mendota Community Hospital d/b/a OSF Saint Paul Medical Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141310-00
Entity Address
1401 E. 12th St.
MENDOTA, IL 61342
Medicare Provider Number
141310
Participating Start Date
1/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
Walgreen CO
Pharmacy Address
DBA Walgreens Central Fill #21417
599 S Schmidt Rd
Ste A
Bolingbrook, IL 60440-9405
Pharmacy Comments
Contract Details
Approval Date
4/12/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diane L. McGrew, President
(309) 655-2850
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/12/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session