Contract Pharmacy Details

WALGREEN CO.
CH033180 BALTIMORE MEDICAL SYSTEM, INC.

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 #16190
301 SAINT PAUL ST
BALTIMORE, MD 21202

Pharmacy Comments

Contract Details

Approval Date

7/1/2014

Contract Begin Date

10/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JAY WOLVOVSKY, EXECUTIVE DIRECTOR
(410) 558-4891

Contract Pharmacy Representative

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

Signed By Date

7/1/2014

340B Drug Pricing Program Database