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WALGREEN CO.
DSH370025 SAINT FRANCIS HOSPITAL MUSKOGEE
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Covered Entity Details
Entity Name
SAINT FRANCIS HOSPITAL MUSKOGEE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH370025
Entity Address
300 ROCKEFELLER DRIVE
MUSKOGEE, OK 74401
Medicare Provider Number
370025
Participating Start Date
1/1/2023
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05529
2330 CHANDLER RD
MUSKOGEE, OK 74403
Pharmacy Comments
Contract Details
Approval Date
1/13/2025
Contract Begin Date
1/13/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Deborah D Dage, SRVP/Chief Financial Officer
(918) 494-8418
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/13/2025
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