Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
RWII198011 Delaware HIV Services, INC

Covered Entity Details

Entity Name

Delaware HIV Services, INC

Subdivision Name

Type

Ryan White Part B

340B ID

RWII198011

Entity Address

100 W. 10th Street Suite 415
Wilmington, DE 19801

Grant Number

X07HA00081

Participating Start Date

10/1/2014

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

DBA; WALGREENS #12040
3513 NORTH MARKET STREET
WILMINGTON, DE 19802

Pharmacy Comments

9/30/10 UPDATED PHARMACY NAME (WAS WALGREENS #12040);

Contract Details

Approval Date

1/13/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/4/2019
Pharmacy closed

Contacts

Covered Entity Signing Official

Peter Houle, Executive Director
(302) 654-5471

Contract Pharmacy Representative

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

Signed By Date

1/13/2015

340B Drug Pricing Program Database