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WALGREEN EASTERN CO., INC.
HV00553 PHILADELPHIA FIGHT
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Covered Entity Details
Entity Name
PHILADELPHIA FIGHT
Subdivision Name
Type
Ryan White Part C
340B ID
HV00553
Entity Address
1233 LOCUST STREET, FOURTH FLOOR
PHILADELPHIA, PA 19107
Grant Number
H76HA00553
Participating Start Date
4/1/2008
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 03791
2014-24 S BROAD ST
PHILADELPHIA, PA 19145
Pharmacy Comments
Contract Details
Approval Date
10/17/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JANE SHULL, EXECUTIVE DIRECTOR
(215) 985-4448 Ext: 102
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/17/2016
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