Contract Pharmacy Details

WALGREEN CO
CAH181329-00 SAINT JOSEPH BEREA HOSPITAL

Covered Entity Details

Entity Name

SAINT JOSEPH BEREA HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH181329-00

Entity Address

305 ESTILL STREET
BEREA, KY 40403

Medicare Provider Number

181329

Participating Start Date

9/30/2010

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO

Pharmacy Address

DBA: WALGREENS #11796
220 RICHMOND RD N
BEREA, KY 40403

Pharmacy Comments

Contract Details

Approval Date

1/17/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Sandra Rose, Vice President of Operations
(859) 986-6559

Contract Pharmacy Representative

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

Signed By Date

1/17/2018

340B Drug Pricing Program Database