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BOND DRUG COMPANY OF ILLINOIS, L.L.C.
RRC140110-00 OTTAWA REGIONAL HOSPITAL & HEALTHCAR
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Covered Entity Details
Entity Name
OTTAWA REGIONAL HOSPITAL & HEALTHCAR
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140110-00
Entity Address
1100 EAST NORRIS DRIVE
OTTAWA, IL 61350
Medicare Provider Number
140110
Participating Start Date
7/1/2015
Last Recertification Date
9/5/2019
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
Pharmacy Address
DBA: WALGREENS # 03089
120 E. MAIN STREET
STREATOR, IL 61364
Pharmacy Comments
Contract Details
Approval Date
7/16/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/14/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Diane L. McGrew, President
(309) 655-2850
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/16/2015
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