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WALGREENS SPECIALTY PHARMACY, LLC
DSH360059 METROHEALTH MEDICAL CENTER
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Covered Entity Details
Entity Name
METROHEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360059
Entity Address
2500 MetroHealth Drive
CLEVELAND, OH 44109-1900
Medicare Provider Number
360059
Participating Start Date
1/1/1994
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
10/13/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Stern, SVP, Chief of Staff
(216) 778-5772
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/13/2016
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