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WALGREEN EASTERN CO INC
CH031670 PUBLIC HEALTH MANAGEMENT CORPORATION
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Covered Entity Details
Entity Name
PUBLIC HEALTH MANAGEMENT CORPORATION
Subdivision Name
Public Health Management Corporation
Type
HRSA-Funded Health Center
340B ID
CH031670
Entity Address
Centre Square East
1500 Market Street
Philadelphia, PA 19102-2100
Grant Number
H80CS00016
Participating Start Date
7/1/2004
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO INC
Pharmacy Address
DBA: WALGREENS # 04115
4201 N BROAD ST
PHILADELPHIA, PA 19140
Pharmacy Comments
Contract Details
Approval Date
4/12/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/11/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Richard Cohen, President and CEO
(215) 985-2501
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/12/2018
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