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WALGREEN CO.
PED503300-00 SEATTLE CHILDREN'S HOSPITAL
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Covered Entity Details
Entity Name
SEATTLE CHILDREN'S HOSPITAL
Subdivision Name
Type
Children's Hospital
340B ID
PED503300-00
Entity Address
4800 Sand Point Way NE
SEATTLE, WA 98105
Medicare Provider Number
503300
Participating Start Date
9/29/2010
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16403
1409 11TH AVE.
SEATTLE, WA 98122
Pharmacy Comments
Contract Details
Approval Date
10/10/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Warren E Hewitt, VP, Finance and Chief Accounting Officer
(206) 884-2378
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/10/2024
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