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WALGREEN CO.
DSH450236 CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance
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Covered Entity Details
Entity Name
CHRISTUS Mother Frances Hospital-Sulphur Springs - CHRISTUS Hopkins Health Alliance
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450236
Entity Address
115 AIRPORT ROAD
SULPHUR SPRINGS, TX 75482
Medicare Provider Number
450236
Participating Start Date
1/1/2018
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11910
1130 S. BROADWAY ST.
SULPHUR SPRINGS, TX 75482-4840
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
Paul Harvey, CEO
(903) 439-4052
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2018
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