Contract Pharmacy Details

WALGREEN CO.
DSH240020 CAMBRIDGE MEDICAL CENTER

Covered Entity Details

Entity Name

CAMBRIDGE MEDICAL CENTER

Subdivision Name

Hospital

Type

Disproportionate Share Hospital

340B ID

DSH240020

Entity Address

701 SOUTH DELLWOOD
CAMBRIDGE, MN 55008

Medicare Provider Number

240020

Participating Start Date

10/1/2019

Last Recertification Date

8/13/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 02460
115 GARFIELD STREET N
CAMBRIDGE, MN 55008-1765

Pharmacy Comments

Contract Details

Approval Date

10/6/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785

Contract Pharmacy Representative

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

Signed By Date

10/6/2023

340B Drug Pricing Program Database