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WALGREEN EASTERN CO., INC.
CHC11299-00 CODMAN SQUARE HEALTH CENTER, INC
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Covered Entity Details
Entity Name
CODMAN SQUARE HEALTH CENTER, INC
Subdivision Name
Codman Square Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11299-00
Entity Address
637 Washington St.
Dorchester, MA 02124-3510
Grant Number
H80CS11299
Participating Start Date
7/1/2012
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 03016
416 WARREN ST
ROXBURY, MA 02119
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Sandra Cotterell, CEO
(617) 822-8123
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/16/2018
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