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WALGREEN CO.
CAH451397-00 SCOTT & WHITE HOSPITAL BRENHAM
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Covered Entity Details
Entity Name
SCOTT & WHITE HOSPITAL BRENHAM
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH451397-00
Entity Address
700 MEDICAL PARKWAY
Brenham, TX 77833
Medicare Provider Number
451397
Participating Start Date
7/29/2022
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #10944
2411 S. DAY ST.
BRENHAM, TX 77833-5518
Pharmacy Comments
Contract Details
Approval Date
4/21/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Jennings, President
(979) 207-4043
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/21/2023
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