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WALGREEN EASTERN CO., INC.
DSH310038 ROBERT WOOD JOHNSON UNIVERSITY HOSP
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Covered Entity Details
Entity Name
ROBERT WOOD JOHNSON UNIVERSITY HOSP
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310038
Entity Address
ONE ROBERT WOOD JOHNSON PLACE
NEW BRUNSWICK, NJ 08901-2601
Medicare Provider Number
310038
Participating Start Date
7/1/2015
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 07056
555 INMAN AVE
COLONIA, NJ 07067
Pharmacy Comments
Contract Details
Approval Date
1/20/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/11/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kenneth M. Wright, VP of Finance & Chief Financial Officer
(732) 418-8410
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/20/2016
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