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WALGREENS SPECIALTY PHARMACY, LLC
CAH341327-00 J ARTHUR DOSHER MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
J ARTHUR DOSHER MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH341327-00
Entity Address
924 N HOWE ST
SOUTHPORT, NC 28461
Medicare Provider Number
341327
Participating Start Date
7/1/2011
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
4/16/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dan Porter, CFO
(910) 457-3912
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/16/2016
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