340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
DSH460004 IHC Health Services Inc. DBA Intermountain Health McKay-Dee Hospital
Print
Covered Entity Details
Entity Name
IHC Health Services Inc. DBA Intermountain Health McKay-Dee Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH460004
Entity Address
4401 HARRISON BLVD
OGDEN, UT 84403
Medicare Provider Number
460004
Participating Start Date
6/15/2020
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 02527
255 36TH ST
SOUTH OGDEN, UT 84405-7120
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kerry Gillespie, CFO-Specialty Based Care
(801) 442-2459
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/12/2018
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