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WALGREEN EASTERN CO., INC.
DSH330027 NASSAU HEALTH CARE CORPORATION
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Covered Entity Details
Entity Name
NASSAU HEALTH CARE CORPORATION
Subdivision Name
Nassau University Medical Center
Type
Disproportionate Share Hospital
340B ID
DSH330027
Entity Address
2201 HEMPSTEAD TURNPIKE
EAST MEADOW, NY 11554
Medicare Provider Number
330027
Participating Start Date
1/1/2004
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 04920
918 MAIN STREET
SUITE 20
SOUTH FARMINGDALE, NY 11735
Pharmacy Comments
6/9/11 UPDATED ADDR (WAS 918 MAIN STREET)
Contract Details
Approval Date
4/15/2011
Contract Begin Date
5/23/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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