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WALGREENS SPECIALTY PHARMACY, LLC
CAH141329-00 MORRISON COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
MORRISON COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH141329-00
Entity Address
303 N. JACKSON STREET
MORRISON, IL 61270
Medicare Provider Number
141329
Participating Start Date
1/1/2016
Last Recertification Date
8/15/2024
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
7/6/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cami Megli, CFO
(815) 772-5533 Ext: 284
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/6/2016
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