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WALGREEN EASTERN CO., INC.
FQHCLA319 COMMUNITY MEDICAL AND DENTAL CARE, INC
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Covered Entity Details
Entity Name
COMMUNITY MEDICAL AND DENTAL CARE, INC
Subdivision Name
Monsey Family Medical Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA319
Entity Address
40 Robert Pitt Dr
Monsey, NY 10952-3333
Grant Number
LALCS00146
Participating Start Date
1/1/2014
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #17731
199 E RIDGEWOOD AVE
RIDGEWOOD, NJ 07450-3815
Pharmacy Comments
Contract Details
Approval Date
10/11/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mendel Hoffman, CEO
(845) 352-6800 Ext: 3812
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/11/2019
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