340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
CAH231332-00 BRONSON LAKEVIEW HOSPITAL
Print
Covered Entity Details
Entity Name
BRONSON LAKEVIEW HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH231332-00
Entity Address
408 HAZEN STREET
PAW PAW, MI 49079
Medicare Provider Number
231332
Participating Start Date
4/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 10081
5933 S WESTNEDGE AVE
PORTAGE, MI 49002-1455
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James B. Falahee Jr., Sr. Vice President, Legal & Legislative Affairs
(269) 341-8907
Contract Pharmacy Representative
Walgreen Co.
Karl Meehan, VP, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2018
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