Contract Pharmacy Details

BOND DRUG COMPANY OF ILLINOIS, L.L.C.
DSH140091 The Carle Foundation Hospital

Covered Entity Details

Entity Name

The Carle Foundation Hospital

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH140091

Entity Address

611 West Park Street
Urbana, IL 61801

Medicare Provider Number

140091

Participating Start Date

10/1/2012

Last Recertification Date

9/4/2024

Pharmacy Details

Pharmacy Name

BOND DRUG COMPANY OF ILLINOIS, L.L.C.

Pharmacy Address

DBA: WALGREENS # 05444
212 S LOGAN AVE
MATTOON, IL 61938

Pharmacy Comments

Contract Details

Approval Date

1/12/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Dennis P. Hesch, Executive VP and CFO
(217) 326-8231

Contract Pharmacy Representative

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

Signed By Date

1/12/2016

340B Drug Pricing Program Database