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WALGREEN EASTERN CO., INC.
SCH330218-00 Oswego Hospital
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Covered Entity Details
Entity Name
Oswego Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH330218-00
Entity Address
110 West 6th Street
Oswego, NY 13126
Medicare Provider Number
330218
Participating Start Date
12/2/2011
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #17389
201 W BROADWAY
FULTON, NY 13069
Pharmacy Comments
Contract Details
Approval Date
3/22/2018
Contract Begin Date
3/22/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric T. Campbell, CFO
(315) 349-5531
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
3/22/2018
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