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WALGREEN CO.
DSH340091 THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
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Covered Entity Details
Entity Name
THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340091
Entity Address
1200 NORTH ELM STREET
GREENSBORO, NC 27401-1020
Medicare Provider Number
340091
Participating Start Date
4/1/2006
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #19949
901 E BESSEMER AVE
GREENSBORO, NC 27405
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
4/19/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeffrey Jones, Executive VP and CFO
(336) 832-8005
Contract Pharmacy Representative
Cone Health
Alex Kidd, Pharmacy Business Manager
(336) 890-3625
Signed By Date
4/13/2018
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