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WALGREENS SPECIALTY PHARMACY, LLC
STD18017 Novus Adult Care Services
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Covered Entity Details
Entity Name
Novus Adult Care Services
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD18017
Entity Address
1565 Linden Street
Bethlehem, PA 18017
Grant Number
NH25PS005144
Participating Start Date
4/1/2016
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Allen C Smith, owner
(610) 867-5365
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2019
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