Contract Pharmacy Details

WALGREENS OF NORTH CAROLINA INC.
DSH340008 SCOTLAND MEMORIAL HOSPITAL

Covered Entity Details

Entity Name

SCOTLAND MEMORIAL HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH340008

Entity Address

500 LAUCHWOOD DRIVE
LAURINBURG, NC 28352

Medicare Provider Number

340008

Participating Start Date

7/1/2004

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

WALGREENS OF NORTH CAROLINA INC.

Pharmacy Address

DBA: WALGREENS #16119
503 E 3RD STREET
P.O. BOX 188
PEMBROKE, NC 28372

Pharmacy Comments

Contract Details

Approval Date

7/20/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/27/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

GREG WOOD, PRESIDENT AND CEO
(910) 291-7000 Ext: 7501

Contract Pharmacy Representative

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

Signed By Date

7/20/2015

340B Drug Pricing Program Database