Contract Pharmacy Details

WALGREEN CO.
RWI20722D GREATER BADEN MEDICAL SERVICES, INC.

Covered Entity Details

Entity Name

GREATER BADEN MEDICAL SERVICES, INC.

Subdivision Name

WALKER MILL HEALTH CENTER

Type

Ryan White Part A

340B ID

RWI20722D

Entity Address

1458 ADDISON ROAD SOUTH
CAPITOL HEIGHTS, MD 20743-4413

Grant Number

H89HA00012

Participating Start Date

4/1/2004

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #17859
5741 SILVER HILL RD
DISTRICT HEIGHTS, MD 20747

Pharmacy Comments

Contract Details

Approval Date

7/14/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Christopher A DeMarco, Chief Executive Officer
(301) 888-2233 Ext: 3306

Contract Pharmacy Representative

Greater Baden Medical Services, Inc.
David Houston, Pharmacist
(301) 888-2233 Ext: 3220

Signed By Date

7/14/2020

340B Drug Pricing Program Database