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WALGREEN EASTERN CO., INC.
DSH330125 ROCHESTER GENERAL HOSPITAL
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Covered Entity Details
Entity Name
ROCHESTER GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330125
Entity Address
1425 PORTLAND AVENUE
ROCHESTER, NY 14621
Medicare Provider Number
330125
Participating Start Date
10/1/2019
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16563
1010 MAIN ST
SUITE 100
BUFFALO, NY 14202
Pharmacy Comments
Contract Details
Approval Date
7/23/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Hugh Thomas, Executive Vice President, Chief Administrative Officer
(585) 922-4941
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/14/2019
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