Contract Pharmacy Details

WALGREEN CO.
CAH181324-00 THE MEDICAL CENTER AT SCOTTSVILLE

Covered Entity Details

Entity Name

THE MEDICAL CENTER AT SCOTTSVILLE

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH181324-00

Entity Address

456 BURNLEY ROAD
SCOTTSVILLE, KY 42164

Medicare Provider Number

181324

Participating Start Date

4/1/2011

Last Recertification Date

9/6/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #19765
385 OLD GALLATIN RD
SCOTTSVILLE, KY 42164

Pharmacy Comments

Contract Details

Approval Date

4/13/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Wade R. Stone, Executive Vice President
(270) 745-1504

Contract Pharmacy Representative

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

Signed By Date

4/13/2023

340B Drug Pricing Program Database