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WALGREEN EASTERN CO., INC.
RRC220110-00 BRIGHAM AND WOMENS HOSPITAL
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Covered Entity Details
Entity Name
BRIGHAM AND WOMENS HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC220110-00
Entity Address
75 FRANCIS STREET
BOSTON, MA 02115
Medicare Provider Number
220110
Participating Start Date
1/1/2019
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 04729
951 BOSTON PROVIDENCE TPKE
NORWOOD, MA 02062
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/13/2023
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