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WALGREEN CO.
DSH380021 TUALITY HEALTHCARE
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Covered Entity Details
Entity Name
TUALITY HEALTHCARE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH380021
Entity Address
335 SE 8TH AVE
HILLSBORO, OR 97123
Medicare Provider Number
380021
Participating Start Date
7/1/2010
Last Recertification Date
9/2/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #13780
955 SE BASELINE ST.
HILLSBORO, OR 97123-4207
Pharmacy Comments
Contract Details
Approval Date
4/23/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TIMOTHY L. FLEISCHMANN, CFO
(503) 681-1579
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/23/2013
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