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WALGREEN EASTERN CO INC
CH012010 MATTAPAN COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
MATTAPAN COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Mattapan Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH012010
Entity Address
1575 Blue Hill Ave
Mattapan, MA 02126-2122
Grant Number
H80CS00395
Participating Start Date
7/1/2002
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO INC
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #15307
21 STANHOPE STREET #23
BOSTON, MA 02116
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GUALE VALDEZ, CEO
(617) 898-9020
Contract Pharmacy Representative
Mattapan Community Health Center
Regina Izmaylova, Chief Financial Officer
(617) 898-9041
Signed By Date
7/7/2020
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