Contract Pharmacy Details

WALGREEN CO.
RRC510050-00 WHEELING HOSPITAL

Covered Entity Details

Entity Name

WHEELING HOSPITAL

Subdivision Name

Type

Rural Referral Center

340B ID

RRC510050-00

Entity Address

1 MEDICAL PARK
WHEELING, WV 26003

Medicare Provider Number

510050

Participating Start Date

4/1/2022

Last Recertification Date

8/23/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #19991
126 12TH ST.
WELLSBURG, WV 26070-1572

Pharmacy Comments

Contract Details

Approval Date

7/15/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Heidi Porter L Porter, Vice President of Quality and Regulatory Affairs
(304) 243-8377

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

7/15/2024

340B Drug Pricing Program Database