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WALGREEN EASTERN CO., INC.
DSH330231 QUEENS HOSPITAL CENTER (NYCHHC)
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Covered Entity Details
Entity Name
QUEENS HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330231
Entity Address
82-68 164TH ST.
JAMAICA, NY 11432
Medicare Provider Number
330231
Participating Start Date
12/1/1992
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #16511
306 CLARKSON AVE.
BROOKLYN, NY 11226
Pharmacy Comments
Contract Details
Approval Date
6/30/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/30/2020
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