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WALGREEN CO
CH010170 Harbor Health Services, Inc.
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Covered Entity Details
Entity Name
Harbor Health Services, Inc.
Subdivision Name
DANIEL DRISCOLL - NEPONSET HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH010170
Entity Address
398 NEPONSET AVE
DORCHESTER, MA 02122
Grant Number
H80CS00743
Participating Start Date
4/1/2002
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS
28727 OREGON ROAD
PERRYSBURG, OH 43551
Pharmacy Comments
ATTN: C II manager
Contract Details
Approval Date
12/4/2012
Contract Begin Date
12/4/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
DANIEL J. DRISCOLL, CEO
(617) 533-2300
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
9/28/2012
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