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WALGREENS OF NORTH CAROLINA INC.
DSH340069 WAKEMED
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Covered Entity Details
Entity Name
WAKEMED
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340069
Entity Address
3000 NEW BERN AVENUE
RALEIGH, NC 27610
Medicare Provider Number
340069
Participating Start Date
1/1/2016
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
WALGREENS OF NORTH CAROLINA INC.
Pharmacy Address
DBA: WALGREENS #16147
4441 SIX FORKS ROAD
STE 110
RALEIGH, NC 27609
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mike Browning, Executive VP of Finance, CFO
(919) 350-8118
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2016
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