340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH500049 WALLA WALLA GENERAL HOSPITAL
Print
Covered Entity Details
Entity Name
WALLA WALLA GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500049
Entity Address
1025 SOUTH SECOND AVE.
WALLA WALLA, WA 99362
Medicare Provider Number
500049
Participating Start Date
7/1/2006
Last Recertification Date
8/30/2016
Entity Termination Date
10/1/2017
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 10107
633 W TIETAN STREET
WALLA WALLA, WA 99362
Pharmacy Comments
Contract Details
Approval Date
4/6/2011
Contract Begin Date
4/15/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2017
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
3/28/2011
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