Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CH02071B CITY OF NEWARK, NEW JERSEY

Covered Entity Details

Entity Name

CITY OF NEWARK, NEW JERSEY

Subdivision Name

Mary Eliza Mahoney Health Center @ 140 Bergen Street

Type

HRSA-Funded Health Center

340B ID

CH02071B

Entity Address

140 Bergen St
Newark, NJ 07103-2425

Grant Number

H80CS00009

Participating Start Date

4/1/2018

Last Recertification Date

2/27/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

WALGREENS #19866
1084 BROAD ST
NEWARK, NJ 07102

Pharmacy Comments

Contract Details

Approval Date

4/15/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/1/2022
Pharmacy closed

Contacts

Covered Entity Signing Official

Mark J Wade, CEO
(973) 733-5310

Contract Pharmacy Representative

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

Signed By Date

4/15/2020

340B Drug Pricing Program Database