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WALGREEN EASTERN CO., INC.
CH010600 FENWAY COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
FENWAY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Fenway Health, Ansin Building
Type
HRSA-Funded Health Center
340B ID
CH010600
Entity Address
1340 Boylston St
Boston, MA 02215
Grant Number
H80CS00303
Participating Start Date
1/1/2004
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
RITE AID #10148
100 CAMBRIDGE ST
SUITE 102
BOSTON, MA 02114
Pharmacy Comments
Contract Details
Approval Date
4/20/2018
Contract Begin Date
4/23/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/19/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
JEFFREY LIEBERMAN, VP of Finance
(617) 927-6173
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/20/2018
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