340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN EASTERN CO., INC.
DSH330194 MAIMONIDES MEDICAL CENTER
Print
Covered Entity Details
Entity Name
MAIMONIDES MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330194
Entity Address
4802 TENTH AVE.
BROOKLYN, NY 11219
Medicare Provider Number
330194
Participating Start Date
10/1/2004
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #19158
1419 NEWKIRK AVE
BROOKLYN, NY 11226-6521
Pharmacy Comments
Contract Details
Approval Date
3/28/2018
Contract Begin Date
3/28/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KENNETH D. GIBBS, CEO
(718) 283-6575
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
3/28/2018
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session