Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CHC16639-02 COMMUNITY HEALTH CENTER OF RICHMOND, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTER OF RICHMOND, INC.

Subdivision Name

CHCR - 135 Canal St, 3rd Floor

Type

HRSA-Funded Health Center

340B ID

CHC16639-02

Entity Address

135 CANAL ST
STATEN ISLAND, NY 10304-2059

Grant Number

H80CS16639

Participating Start Date

7/1/2016

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

DBA: WALGREENS #01598
1579 FOREST AVE.
STATEN ISLAND, NY 10302-2226

Pharmacy Comments

Contract Details

Approval Date

4/19/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Walgreens
Rishabh Dave, 340B Operations Analyst
(847) 964-8379

Signed By Date

340B Drug Pricing Program Database