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WALGREEN EASTERN CO., INC.
RRC390195-00 LANKENAU MEDICAL CENTER
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Covered Entity Details
Entity Name
LANKENAU MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC390195-00
Entity Address
100 LANCASTER AVE.
WYNNEWOOD, PA 19096
Medicare Provider Number
390195
Participating Start Date
1/1/2020
Last Recertification Date
8/31/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 06837
699 W GERMANTOWN PIKE
EAST NORRITON, PA 19403-4233
Pharmacy Comments
Contract Details
Approval Date
7/16/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Phil D Robinson, President
(484) 476-2027
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/16/2020
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