Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CH020110 WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.

Covered Entity Details

Entity Name

WHITNEY M. YOUNG, JR., HEALTH CENTER, INC.

Subdivision Name

WHITNEY M. YOUNG, JR. HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH020110

Entity Address

920 Lark Dr
Albany, NY 12207-1300

Grant Number

H80CS00433

Participating Start Date

10/1/1995

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

RITE AID #03334
310 S PEARL ST
ALBANY, NY 12202

Pharmacy Comments

Contract Details

Approval Date

3/21/2018

Contract Begin Date

3/21/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2018
Pharmacy closed

Contacts

Covered Entity Signing Official

David H. Shippee, President & CEO
(518) 591-4459

Contract Pharmacy Representative

Walgreen CO.
Ruben Gonzales, Analyst
(847) 964-8686

Signed By Date

3/21/2018

340B Drug Pricing Program Database