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WALGREENS MAIL SERVICE, LLC
PED033302-00 PHOENIX CHILDREN'S HOSPITAL
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Covered Entity Details
Entity Name
PHOENIX CHILDREN'S HOSPITAL
Subdivision Name
Type
Children's Hospital
340B ID
PED033302-00
Entity Address
1919 E THOMAS ROAD
PHOENIX, AZ 85016
Medicare Provider Number
033302
Participating Start Date
4/1/2010
Last Recertification Date
9/19/2024
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, LLC
Pharmacy Address
WALGREENS MAIL SERVICE #03397
8350 S RIVER PARKWAY
TEMPE, AZ 85284
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Douglas T Myers, CFO
(602) 933-1393
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/16/2018
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