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WALGREENS SPECIALTY PHARMACY, LLC
CAH171384-00 NEWMAN MEMORIAL COUNTY HOSPITAL
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Covered Entity Details
Entity Name
NEWMAN MEMORIAL COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171384-00
Entity Address
1201 W. 12th Ave.
EMPORIA, KS 66801
Medicare Provider Number
171384
Participating Start Date
1/1/2016
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Holly R. French, CFO
(620) 343-6800 Ext: 22610
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/12/2018
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