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WALGREEN EASTERN CO., INC.
CH01164D MANET COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
MANET COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
MANET CHC AT QUINCY MEDICAL CTR
Type
HRSA-Funded Health Center
340B ID
CH01164D
Entity Address
114 Whitwell St
Quincy, MA 02169-1870
Grant Number
H80CS00453
Participating Start Date
4/1/2004
Last Recertification Date
2/1/2017
Entity Termination Date
4/1/2018
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 01847
757 GALLIVAN BLVD STE 3
DORCHESTER, MA 02122
Pharmacy Comments
Contract Details
Approval Date
12/4/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
HENRY N. TUTTLE, CEO
(857) 403-0446
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2012
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