340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH100022 JACKSON HEALTH SYSTEM
Print
Covered Entity Details
Entity Name
JACKSON HEALTH SYSTEM
Subdivision Name
JACKSON MEMORIAL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH100022
Entity Address
1611 NW 12 AVE.
MIAMI, FL 33136
Medicare Provider Number
100022
Participating Start Date
12/1/1992
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 02719
791 NE 167TH ST
NORTH MIAMI BEACH, FL 33162
Pharmacy Comments
Contract Details
Approval Date
4/14/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carlos A. Migoya, CEO
(305) 585-6754
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/14/2016
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session