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WALGREEN EASTERN CO., INC.
DSH310027 TRINITAS REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
TRINITAS REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310027
Entity Address
225 WILLIAMSON ST
ELIZABETH, NJ 07202
Medicare Provider Number
310027
Participating Start Date
1/1/2005
Last Recertification Date
9/1/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #16260
36 HILLSIDE AVENUE
HILLSIDE, NJ 07205
Pharmacy Comments
Contract Details
Approval Date
8/13/2012
Contract Begin Date
8/13/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/7/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
KAREN LUMPP, CFO & SENIOR VP
(908) 994-8174
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/25/2012
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