340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH150011 MARION GENERAL HOSPITAL, INC.
Print
Covered Entity Details
Entity Name
MARION GENERAL HOSPITAL, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH150011
Entity Address
441 NORTH WABASH AVENUE
MARION, IN 46952
Medicare Provider Number
150011
Participating Start Date
7/1/2010
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05663
1323 N BALDWIN AVE
MARION, IN 46952
Pharmacy Comments
Contract Details
Approval Date
10/6/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
STEPHANIE HILTON-SIEBERT, CHIEF ADMINISTRATIVE OFFICER
(765) 660-7007
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/6/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session