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WALGREENS SPECIALTY PHARMACY, LLC
SCH060006-00 MONTROSE MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
MONTROSE MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH060006-00
Entity Address
800 S Third Street
MONTROSE, CO 81401
Medicare Provider Number
060006
Participating Start Date
7/1/2025
Last Recertification Date
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
7/7/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2016
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Albert White, CFO
(970) 240-7251
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/7/2015
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