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Walgreens #21423
DSH390041 UNIONTOWN HOSPITAL
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Covered Entity Details
Entity Name
UNIONTOWN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390041
Entity Address
500 WEST BERKELEY STREET
UNIONTOWN, PA 15401
Medicare Provider Number
390041
Participating Start Date
4/1/2005
Last Recertification Date
8/22/2024
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
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lynn Matusik, VP Finance
(724) 430-5727
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2024
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