340B Drug Pricing Program Database
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WALGREEN CO.
CH033180 BALTIMORE MEDICAL SYSTEM, INC.
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Covered Entity Details
Entity Name
BALTIMORE MEDICAL SYSTEM, INC.
Subdivision Name
BMS at Yard 56
Type
HRSA-Funded Health Center
340B ID
CH033180
Entity Address
5525 Eastern Avenue
Suite 301
Baltimore, MD 21224-2029
Grant Number
H80CS00800
Participating Start Date
10/1/1998
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05638
4025 W NORTHERN PKWY
BALTIMORE, MD 21215
Pharmacy Comments
Contract Details
Approval Date
2/21/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jay Wolvovsky, President & CEO
(410) 558-4891
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2013
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