Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
STD1980813 Heritage Medical Associates PA

Covered Entity Details

Entity Name

Heritage Medical Associates PA

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD1980813

Entity Address

2601 Annand Dr.
Suite 4
Wilmington, DE 19808

Grant Number

NH25PS005156

Participating Start Date

7/1/2024

Last Recertification Date

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #16560
532 FEDERAL ST
CAMDEN, NJ 08103

Pharmacy Comments

Contract Details

Approval Date

7/19/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2024
Failed to Respond to CP Integrity Check

Contacts

Covered Entity Signing Official

John Fenice, Owner
(302) 650-0239

Contract Pharmacy Representative

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

Signed By Date

7/19/2024

340B Drug Pricing Program Database