340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
DSH140250 SOUTH SUBURBAN HOSPITAL
Print
Covered Entity Details
Entity Name
SOUTH SUBURBAN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140250
Entity Address
17800 Kedzie Ave
HAZELCREST, IL 60429
Medicare Provider Number
140250
Participating Start Date
10/1/2016
Last Recertification Date
11/9/2017
Entity Termination Date
7/1/2018
Pharmacy Details
Pharmacy Name
BOND DRUG COMPANY OF ILLINOIS, L.L.C.
Pharmacy Address
DBA: WALGREENS # 04532
15 S. ORCHARD DR.
PARK FOREST, IL 60466
Pharmacy Comments
Contract Details
Approval Date
10/12/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Brian Kelly, VP Finance, Advocate Trinity Hospital
(708) 213-3004
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2017
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