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WALGREEN CO.
DSH500027 SWEDISH MEDICAL CENTER
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Covered Entity Details
Entity Name
SWEDISH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500027
Entity Address
747 BROADWAY
SEATTLE, WA 98122
Medicare Provider Number
500027
Participating Start Date
7/1/2006
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #21167
747 BROADWAY AVE STE ET-144
SEATTLE, WA 98122
Pharmacy Comments
Contract Details
Approval Date
10/11/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/19/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Sheri Feeney, Chief Financial Officer
(206) 628-2530
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/11/2017
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