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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
494 NUTT RD.
PHOENIXVILLE, PA 19460-3354
Pharmacy Comments
Contract Details
Approval Date
10/13/2020
Contract Begin Date
1/1/2021
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
10/13/2020
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