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WALGREEN CO.
DSH140292 UChicago Medicine AdventHealth GlenOaks
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Covered Entity Details
Entity Name
UChicago Medicine AdventHealth GlenOaks
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140292
Entity Address
701 WINTHROP AVENUE
GLENDALE HEIGHTS, IL 60139-1405
Medicare Provider Number
140292
Participating Start Date
7/1/2005
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07419
1601 N MAIN STREET
WHEATON, IL 60187-3144
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jared Brown, Chief Financial Officer
(630) 312-6003
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2023
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