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WALGREEN EASTERN CO., INC.
CH02371C INSTITUTE FOR FAMILY HEALTH, THE
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Covered Entity Details
Entity Name
INSTITUTE FOR FAMILY HEALTH, THE
Subdivision Name
SIDNEY HILLMAN and PHILLIPS FAMILY PRACTICE
Type
HRSA-Funded Health Center
340B ID
CH02371C
Entity Address
16 EAST 16TH STREET FL 3RD FLOOR
NEW YORK, NY 10003-3105
Grant Number
H80CS00768
Participating Start Date
1/1/2002
Last Recertification Date
2/15/2017
Entity Termination Date
1/1/2018
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #10912
2575 BROADWAY
NEW YORK, NY 10025
Pharmacy Comments
Contract Details
Approval Date
12/10/2010
Contract Begin Date
12/10/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
8/20/2010
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