Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
DSH190040 Slidell Memorial Hospital

Covered Entity Details

Entity Name

Slidell Memorial Hospital

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH190040

Entity Address

1001 Gause Boulevard
Slidell, LA 70458-2987

Medicare Provider Number

190040

Participating Start Date

10/1/2011

Last Recertification Date

8/27/2024

Pharmacy Details

Pharmacy Name

WALGREENS SPECIALTY PHARMACY, LLC

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #16287
130 ENTERPRISE DR
PITTSBURGH, PA 15275

Pharmacy Comments

Contract Details

Approval Date

1/14/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/15/2019
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Sandy Badinger, Chief Executive Officer
(985) 280-8503

Contract Pharmacy Representative

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

Signed By Date

1/14/2015

340B Drug Pricing Program Database