Contract Pharmacy Details

BOND DRUG COMPANY OF ILLINOIS, L.L.C.
DSH140180 Presence Saints Mary and Elizabeth Medical Center

Covered Entity Details

Entity Name

Presence Saints Mary and Elizabeth Medical Center

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH140180

Entity Address

2233 WEST DIVISION STREET
CHICAGO, IL 60622

Medicare Provider Number

140180

Participating Start Date

7/1/2003

Last Recertification Date

8/16/2024

Entity Termination Date

4/1/2025

Pharmacy Details

Pharmacy Name

BOND DRUG COMPANY OF ILLINOIS, L.L.C.

Pharmacy Address

DBA: WALGREENS # 01298
1372 N MILWAUKEE AVE
CHICAGO, IL 60622

Pharmacy Comments

Contract Details

Approval Date

10/15/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Suzanne Lambert, VP Patient Care Services/CNO
(312) 770-2107

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/15/2015

340B Drug Pricing Program Database