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WALGREEN EASTERN CO., INC.
DSH310027 TRINITAS REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
TRINITAS REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310027
Entity Address
225 WILLIAMSON ST
ELIZABETH, NJ 07202
Medicare Provider Number
310027
Participating Start Date
1/1/2005
Last Recertification Date
9/1/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
RITE AID #01105
160 WASHINGTON AVE
CARTERET, NJ 07008
Pharmacy Comments
Contract Details
Approval Date
6/18/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/12/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
Nancy DiLiegro, Vice President of Clinical Operations and Physician Services, Chief Clinical Officer
(908) 994-5226
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/18/2018
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