Contract Pharmacy Details

WALGREEN CO.
STD20017 Washington Health Institute

Covered Entity Details

Entity Name

Washington Health Institute

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD20017

Entity Address

1140 Varnum Street NE
PMB; Suite # 203
Washington, DC 20017-2153

Grant Number

1NH25PS005133-01-00

Participating Start Date

7/1/2019

Last Recertification Date

5/7/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

COMMUNITY, A WALGREENS PHARMACY #21166
1114 CATHEDRAL ST.
SUITE 3
BALTIMORE, MD 21201

Pharmacy Comments

Contract Details

Approval Date

7/11/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jose Bordon, Chief Executive Officer
(240) 426-8890

Contract Pharmacy Representative

Walgreens
Joyce Abraham, Analyst, 340B Client Relationship
(847) 964-6382

Signed By Date

7/11/2022

340B Drug Pricing Program Database