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WALGREEN CO
CH033770 GREATER BADEN MEDICAL SERVICE INC
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Covered Entity Details
Entity Name
GREATER BADEN MEDICAL SERVICE INC
Subdivision Name
Greater Baden Medical Services at Brandywine
Type
HRSA-Funded Health Center
340B ID
CH033770
Entity Address
7450 Albert Road
Brandywine, MD 20613
Grant Number
H80CS00549
Participating Start Date
4/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #09632
2970 SHASHO PLACE
WALDORF, MD 20603
Pharmacy Comments
Contract Details
Approval Date
10/22/2012
Contract Begin Date
10/22/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sarah Leonhard, Consultant
(301) 518-2349
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
9/21/2012
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