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WALGREEN CO.
RWI20722E GREATER BADEN MEDICAL SERVICES, INC.
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Covered Entity Details
Entity Name
GREATER BADEN MEDICAL SERVICES, INC.
Subdivision Name
GREATER BADEN AT BRANDYWINE
Type
Ryan White Part A
340B ID
RWI20722E
Entity Address
7450 ALBERT Rd
3rd fl
BRANDYWINE, MD 20613
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
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