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WALGREEN CO
DSH260102 Truman Medical Center, Incorporated dba University Health Lakewood Medical Center
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Covered Entity Details
Entity Name
Truman Medical Center, Incorporated dba University Health Lakewood Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH260102
Entity Address
7900 Lee's Summit Road
Kansas City, MO 64139
Medicare Provider Number
260102
Participating Start Date
4/1/2001
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11925
400 S. BROADWAY
OAK GROVE, MO 64075
Pharmacy Comments
Contract Details
Approval Date
4/20/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lynda Donegan, Vice President/Professional Health Services
(816) 404-3528 Ext: 8164043672
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/20/2016
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