340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH490114 LONESOME PINE HOSPITAL
Print
Covered Entity Details
Entity Name
LONESOME PINE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH490114
Entity Address
1990 HOLTON AVENUE EAST
BIG STONE GAP, VA 24219
Medicare Provider Number
490114
Participating Start Date
10/1/2006
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09459
6740 BRISTOL HWY
PINEY FLATS, TN 37686
Pharmacy Comments
Contract Details
Approval Date
4/22/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/17/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Alice Pope, EVP and CFO
(423) 230-8209
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/22/2015
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