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WALGREEN CO.
CAH041330-00 Piggott Community Hospital
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Covered Entity Details
Entity Name
Piggott Community Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH041330-00
Entity Address
1206 Gordon Duckworth Drive
Piggott, AR 72454-1911
Medicare Provider Number
041330
Participating Start Date
4/1/2014
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #15800
904 WEST BUSINESS HWY 60
DEXTER, MO 63841
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Magee., Executive Director
(870) 598-3881 Ext: 1200
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2023
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