Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
DSH220116 TUFTS MEDICAL CENTER

Covered Entity Details

Entity Name

TUFTS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH220116

Entity Address

800 WASHINGTON STREET
BOSTON, MA 02111

Medicare Provider Number

220116

Participating Start Date

10/1/2003

Last Recertification Date

8/13/2024

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

WALGREENS SPECIALTY PHARMACY #21179
25 MERRIMACK ST.
LOWELL, MA 01852

Pharmacy Comments

Contract Details

Approval Date

7/9/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Assad Siddiqi, Senior Vice President of Finance
(617) 636-7767

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

7/9/2024

340B Drug Pricing Program Database