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WALGREEN EASTERN CO., INC.
HV022690 NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
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Covered Entity Details
Entity Name
NEW YORK CITY HEALTH AND HOSPITALS CORPORATION
Subdivision Name
SYDENHAM HEALTH CARE NETWORK
Type
Ryan White Part C
340B ID
HV022690
Entity Address
264 W 118th St
NEW YORK, NY 10026
Grant Number
H76HA00034
Participating Start Date
12/1/1992
Last Recertification Date
2/8/2018
Entity Termination Date
10/1/2018
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #13755
364 SPRINGFIELD AVE
SUMMIT, NJ 07901
Pharmacy Comments
Contract Details
Approval Date
1/19/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Antonio Martin, Ececutive Vice President & Chief Operating Officier
(212) 788-3479
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/19/2017
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