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WALGREEN EASTERN CO., INC.
FQHCLA370 His Branches, Inc.
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Covered Entity Details
Entity Name
His Branches, Inc.
Subdivision Name
His Branches Inc.: Grace Family Medicine
Type
Health Center Program Look-Alike
340B ID
FQHCLA370
Entity Address
340 ARNETT BLVD
ROCHESTER, NY 14619-1147
Grant Number
LALCS31626
Participating Start Date
7/1/2018
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #19354
437 LYELL AVE
ROCHESTER, NY 14606
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janet Thirlby, Executive Director
(585) 235-9000 Ext: 236
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2020
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