Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CAH301304-00 THE NEW LONDON HOSPITAL ASSOCIATION, INC

Covered Entity Details

Entity Name

THE NEW LONDON HOSPITAL ASSOCIATION, INC

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH301304-00

Entity Address

273 COUNTY ROAD
NEW LONDON, NH 03257

Medicare Provider Number

301304

Participating Start Date

9/20/2010

Last Recertification Date

8/14/2024

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

DBA: WALGREENS #10780
1 GLENWOOD AVE.
DOVER, NH 03820-2406

Pharmacy Comments

Contract Details

Approval Date

1/19/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/28/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Martin Thomas Manion, President and Chief Executive Officer
(603) 526-5241

Contract Pharmacy Representative

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

Signed By Date

1/19/2022

340B Drug Pricing Program Database