Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CH031260 SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.

Covered Entity Details

Entity Name

SOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.

Subdivision Name

DBA HENRIETTA JOHNSON MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH031260

Entity Address

601 NEW CASTLE AVENUE
WILMINGTON, DE 19801

Grant Number

H80CS00385

Participating Start Date

10/13/2005

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

DBA; WALGREENS #12040
3513 NORTH MARKET STREET
WILMINGTON, DE 19802

Pharmacy Comments

9/30/10 UPDATED PHARMACY NAME (WAS WALGREENS #12040);

Contract Details

Approval Date

4/6/2015

Contract Begin Date

7/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/7/2019
Pharmacy closed

Contacts

Covered Entity Signing Official

Yvette Gbemudu, CMO
(302) 655-6187 Ext: 528

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/6/2015

340B Drug Pricing Program Database