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WALGREEN EASTERN CO., INC.
CHC26634-00 PHILADELPHIA FIGHT
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Covered Entity Details
Entity Name
PHILADELPHIA FIGHT
Subdivision Name
Philadelphia FIGHT Jonathan Lax Treatment Center
Type
HRSA-Funded Health Center
340B ID
CHC26634-00
Entity Address
1233 Locust Street Floor 5, Suite 500 and Floor 4, Suite 400
Philadelphia, PA 19107-5453
Grant Number
H80CS26634
Participating Start Date
4/1/2014
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15316
1227 LOCUST ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
4/17/2014
Contract Begin Date
7/1/2014
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
4/17/2014
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