340B Drug Pricing Program Database
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Walgreens #21423
DSH390113 Meadville Medical Center
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Covered Entity Details
Entity Name
Meadville Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390113
Entity Address
751 Liberty Street
Meadville, PA 16335
Medicare Provider Number
390113
Participating Start Date
7/1/2013
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
Walgreens #21423
Pharmacy Address
Walgreens Central Fill #21423
6275 Winchester Blvd
Canal WInchester, OH 43110-6537
Pharmacy Comments
Contract Details
Approval Date
10/13/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ellie Jo Amory, 340B Program Administrator
(814) 333-5669
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2023
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