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WALGREEN EASTERN CO., INC.
CH012010 MATTAPAN COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
MATTAPAN COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Mattapan Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH012010
Entity Address
1575 Blue Hill Ave
Mattapan, MA 02126-2122
Grant Number
H80CS00395
Participating Start Date
7/1/2002
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #15001
980 AMERICAN LEGION HWY
ROSLINDALE, MA 02131-4701
Pharmacy Comments
02/25/2013 corrected address error (was store #05756); 11/05/2012 store relocation (was Walgreens #1849 972 AMERICAN LEGION HWY ROSLINDALE MA 02131)
Contract Details
Approval Date
1/9/2012
Contract Begin Date
1/9/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
AZZIE YOUNG, CEO
(617) 898-9020
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/21/2012
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