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WALGREEN EASTERN CO., INC.
CH032900 DELAWARE VALLEY COMMUNITY HEALTH, INC.
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Covered Entity Details
Entity Name
DELAWARE VALLEY COMMUNITY HEALTH, INC.
Subdivision Name
Fairmount Primary Care Center
Type
HRSA-Funded Health Center
340B ID
CH032900
Entity Address
1412-22 FAIRMOUNT AVENUE
PHILADELPHIA, PA 19130-2908
Grant Number
H80CS00833
Participating Start Date
1/1/2003
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS
112 W CHELTEN AVE
PHILADELPHIA, PA 19144
Pharmacy Comments
Contract Details
Approval Date
4/4/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PATRICIA DEITCH, CEO
(215) 684-5344
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/4/2016
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