Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
RWI191042 Children's Hospital of Philadelphia

Covered Entity Details

Entity Name

Children's Hospital of Philadelphia

Subdivision Name

Special Immunology/Family Care Clinic

Type

Ryan White Part A

340B ID

RWI191042

Entity Address

3550 Market St.
2nd Floor
Philadelphia, PA 19104

Grant Number

H89HA00013

Participating Start Date

7/1/2015

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #21251
3550 MARKET ST STE 103
PHILADELPHIA, PA 19104

Pharmacy Comments

Contract Details

Approval Date

4/14/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

THOMAS J. TODOROW, EXECUTIVE VICE PRESIDENT FINANCE AND CHIEF FINANCIAL OFFICER
(267) 426-6957

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/14/2020

340B Drug Pricing Program Database