340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH110164 Coliseum Medical Center, Inc. d/b/a Piedmont Macon Medical Center
Print
Covered Entity Details
Entity Name
Coliseum Medical Center, Inc. d/b/a Piedmont Macon Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH110164
Entity Address
350 Hospital Drive
Macon, GA 31217
Medicare Provider Number
110164
Participating Start Date
4/1/2023
Last Recertification Date
8/14/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07229
4305 MERCER UNIVERSITY DRIVE
MACON, GA 31206-4117
Pharmacy Comments
Contract Details
Approval Date
1/8/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Alisha R Neal, Chief Financial Officer PMM & PMN
(478) 464-8140
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/8/2024
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