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WALGREEN CO.
DSH520037 MARSHFIELD MEDICAL CENTER
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Covered Entity Details
Entity Name
MARSHFIELD MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH520037
Entity Address
611 St Joseph Avenue
MARSHFIELD, WI 54449
Medicare Provider Number
520037
Participating Start Date
1/1/2024
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11278
3301 CHURCH ST.
STEVENS POINT, WI 54481-5314
Pharmacy Comments
Contract Details
Approval Date
10/17/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Chaloner, President
(715) 387-7855
Contract Pharmacy Representative
Walgreens
Scott Schuler, Group VP Contracting & Pricing
(800) 925-4733
Signed By Date
10/13/2023
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