Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
DSH180143 SAINT JOSEPH EAST

Covered Entity Details

Entity Name

SAINT JOSEPH EAST

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH180143

Entity Address

150 NORTH EAGLE CREEK DRIVE
LEXINGTON, KY 40509

Medicare Provider Number

180143

Participating Start Date

1/1/2008

Last Recertification Date

8/29/2024

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

1/15/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/8/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Eric Gilliam, President
(859) 967-5750

Contract Pharmacy Representative

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

Signed By Date

1/15/2018

340B Drug Pricing Program Database