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WALGREEN CO.
DSH260048 Truman Medical Center, Incorporated dba University Health Truman Medical Center
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Covered Entity Details
Entity Name
Truman Medical Center, Incorporated dba University Health Truman Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260048
Entity Address
2301 Holmes Street
Kansas City, MO 64108
Medicare Provider Number
260048
Participating Start Date
12/1/1992
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16072
3537 BROADWAY BLVD
KANSAS CITY, MO 64111
Pharmacy Comments
Contract Details
Approval Date
10/31/2012
Contract Begin Date
10/31/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John W. Bluford, President and CEO
(816) 404-3500
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
9/28/2012
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