Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
CAH501315-00 Klickitat County Public Hospital District #2, d/b/a Skyline Hospital

Covered Entity Details

Entity Name

Klickitat County Public Hospital District #2, d/b/a Skyline Hospital

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH501315-00

Entity Address

211 Skyline Drive
White Salmon, WA 98672-0099

Medicare Provider Number

501315

Participating Start Date

1/1/2014

Last Recertification Date

8/18/2024

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

Contract Termination Date
Termination Reason

4/23/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Brenda Schneider, CFO
(509) 637-2901

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/12/2018

340B Drug Pricing Program Database