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WALGREENS SPECIALTY PHARMACY, LLC
DSH210032 UNION HOSPITAL OF CECIL COUNTY
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Covered Entity Details
Entity Name
UNION HOSPITAL OF CECIL COUNTY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH210032
Entity Address
106 BOW STREET
ELKTON, MD 21921
Medicare Provider Number
210032
Participating Start Date
10/1/2015
Last Recertification Date
8/22/2024
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
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Laurie R. Beyer, Sr. VP/CFO
(410) 392-2685
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/17/2017
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