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WALGREENS SPECIALTY PHARMACY, LLC
RWI07960 EDGE New Jersey
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Covered Entity Details
Entity Name
EDGE New Jersey
Subdivision Name
Type
Ryan White Part A
340B ID
RWI07960
Entity Address
35 WATERVIEW BLVD
Suite 201
Parsippany, NJ 07054
Grant Number
H89HA00003
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laurie Litt, Chief Executive Officer
(973) 285-0006 Ext: 15
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2020
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