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WALGREEN EASTERN CO., INC.
DSH330005 KALEIDA HEALTH
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Covered Entity Details
Entity Name
KALEIDA HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330005
Entity Address
100 High Street
BUFFALO, NY 14203
Medicare Provider Number
330005
Participating Start Date
4/1/2006
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16563
1010 MAIN ST
SUITE 100
BUFFALO, NY 14202
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
5/10/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matthew D Drake, EVP Chief Financial Officer
(716) 859-8836
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/17/2023
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