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WALGREENS SPECIALTY PHARMACY, LLC
DSH180011 SAINT JOSEPH HEALTH SYSTEM
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Covered Entity Details
Entity Name
SAINT JOSEPH HEALTH SYSTEM
Subdivision Name
DBA SAINT JOSEPH - LONDON
Type
Disproportionate Share Hospital
340B ID
DSH180011
Entity Address
1001 SAINT JOSEPH LANE
LONDON, KY 40741
Medicare Provider Number
180011
Participating Start Date
4/1/2006
Last Recertification Date
8/21/2024
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
1/16/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/6/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Christy Spitser, Vice President of Finance
(606) 330-6016
Contract Pharmacy Representative
Walgreens
Kirk Butler, National Accounts Director
(847) 315-0270
Signed By Date
1/16/2018
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