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WALGREEN CO.
DSH260141 University of Missouri Health Care
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Covered Entity Details
Entity Name
University of Missouri Health Care
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260141
Entity Address
One Hospital Drive
Columbia, MO 65212
Medicare Provider Number
260141
Participating Start Date
12/1/1992
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12749
900 EASTLAND DRIVE
JEFFERSON CITY, MO 65101
Pharmacy Comments
Contract Details
Approval Date
7/18/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Katrina Lambrecht, Chief Operating Officer
(573) 882-6467
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/18/2023
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