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WALGREEN CO.
DSH500026 SWEDISH EDMONDS
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Covered Entity Details
Entity Name
SWEDISH EDMONDS
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500026
Entity Address
21601 76TH AVENUE WEST
EDMONDS, WA 98026-7507
Medicare Provider Number
500026
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03765
20725 HIGHWAY 99
LYNNWOOD, WA 98036
Pharmacy Comments
Contract Details
Approval Date
10/17/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott Combs, CFO
(425) 261-4044
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/10/2024
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