Contract Pharmacy Details

DUANE READE
FQHCLA334U NEW YORK CITY HEALTH AND HOSPITALS CORPORATION

Covered Entity Details

Entity Name

NEW YORK CITY HEALTH AND HOSPITALS CORPORATION

Subdivision Name

East New York Diagnostic and Treatment Center

Type

Health Center Program Look-Alike

340B ID

FQHCLA334U

Entity Address

2094 Pitkin Ave
Brooklyn, NY 11207-3509

Grant Number

LALCS00169

Participating Start Date

7/1/2015

Last Recertification Date

2/22/2018

Entity Termination Date

4/1/2019

Pharmacy Details

Pharmacy Name

DUANE READE

Pharmacy Address

54-11 MYRTLE AVENUE
RIDGEWOOD, NY 11385

Pharmacy Comments

Contract Details

Approval Date

7/12/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/13/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Antonio Martin, Ececutive Vice President & Chief Operating Officier
(212) 788-3479

Contract Pharmacy Representative

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

Signed By Date

7/12/2016

340B Drug Pricing Program Database