Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CH012010 MATTAPAN COMMUNITY HEALTH CENTER, INC.

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 # 04535
170 N MAIN STREET
RANDOLPH, MA 02368

Pharmacy Comments

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

340B Drug Pricing Program Database