Contract Pharmacy Details

BOND DRUG COMPANY OF ILLINOIS, L.L.C.
DSH140067 SAINT FRANCIS MEDICAL CENTER

Covered Entity Details

Entity Name

SAINT FRANCIS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH140067

Entity Address

530 NE GLEN OAK AVENUE
PEORIA, IL 61637

Medicare Provider Number

140067

Participating Start Date

10/1/2006

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

BOND DRUG COMPANY OF ILLINOIS, L.L.C.

Pharmacy Address

DBA: WALGREENS # 03181
2515 N. KNOXVILLE AVE
PEORIA, IL 61604

Pharmacy Comments

Contract Details

Approval Date

10/21/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/22/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Diane L. McGrew, President
(309) 655-2850

Contract Pharmacy Representative

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

Signed By Date

10/21/2015

340B Drug Pricing Program Database