340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO
DSH170086 STORMONT-VAIL HEALTHCARE INC.
Print
Covered Entity Details
Entity Name
STORMONT-VAIL HEALTHCARE INC.
Subdivision Name
DBA STORMONT VAIL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH170086
Entity Address
1500 SW 10TH AVE
TOPEKA, KS 66604
Medicare Provider Number
170086
Participating Start Date
4/1/2018
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA WALGREENS
5100 LAKE TERRACE NE
MOUNT VERNON, IL 62864
Pharmacy Comments
Contract Details
Approval Date
3/8/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/6/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kevin J. Han, VP, CFO, Treasurer
(785) 354-6076
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session