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WALGREEN CO.
CH036640 CHASE BREXTON HEALTH SERVICES, INC
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Covered Entity Details
Entity Name
CHASE BREXTON HEALTH SERVICES, INC
Subdivision Name
Chase Brexton Health Services, Inc.
Type
HRSA-Funded Health Center
340B ID
CH036640
Entity Address
1111 North Charles Street
Baltimore, MD 21201-5505
Grant Number
H80CS00734
Participating Start Date
4/1/1997
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06265
9110 LIBERTY ROAD
RANDALLSTOWN, MD 21133
Pharmacy Comments
Contract Details
Approval Date
4/15/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bret Minarik, Chief Financial Officer
(410) 752-0954 Ext: 4025
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2013
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