Covered Entity Details

STD337051 West Central Gastroenterology dba Gastro Florida (Active) - information as of 5/30/2025 8:15:41 PM

Main Details

Name

West Central Gastroenterology dba Gastro Florida

Subdivision Name

Gastro Florida Division 7b

Type

Sexually Transmitted Diseases

340B ID

STD337051

Grant Number

H25PS005131

Nature of Support
Please Describe the “in-kind” Support
Time period section 318 funding or in-kind support was received

In-Kind products or services (see note below; must have been purchased with section 318 funds)
Note: In-kind contributions may be in the form of real property, equipment, supplies and other expendable property, and goods and services directly benefiting and specifically identifiable to the project or program.
HIV Test Kits, Condoms, Patient Educational Materials
8/11/2020

Additional Details

Current Program Status

Active

Registration Date

10/4/2021

Participating Start Date

1/1/2022

Participating Approval Date

12/3/2021

Last Recertification Date

5/9/2025

Notice of Funding Opportunity (NOFO) Number

PS19-1901

Contacts

Authorizing Official

West Central Gastroenterology dba Gastro Florida
Seena Salyani, CEO
(727) 347-0536

Primary Contact

West Central Gastroenterology d.b.a. Gastro Florida
Jordan Kutner, Director of Operations
(727) 497-9152

Addresses

Street Address

1201 5th Ave N
Ste 402
Saint Petersburg, FL 33705

Billing Address

West Central Gastroenterology dba Gastro Florida
3001 Executive Dr.
Ste 130
Clearwater, FL 33762

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Shipping Address 1

West Central Gastroenterology dba Gastro Florida
3001 Executive Dr.
Ste 130
Clearwater, FL 33762

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	AB SPECIALTY PHARMACY INC.	2311 SEVEN SPRINGS BLVD		NEW PORT RICHEY	FL	34655	12/03/2021	01/01/2022		01/01/2022
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	07/14/2022	10/01/2022		10/01/2022
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	07/14/2022	10/01/2022		10/01/2022
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	07/14/2022	10/01/2022		10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	07/14/2022	10/01/2022		10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	07/14/2022	10/01/2022		10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	07/14/2022	10/01/2022		10/01/2022
Contract Detail	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	07/14/2022	10/01/2022		10/01/2022
Contract Detail	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	04/15/2024	07/01/2024		07/01/2024
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	12/03/2021	01/01/2022		01/01/2022
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	01/10/2022	04/01/2022		04/01/2022
Contract Detail	ESI MAIL PHARMACY SERVICE	DBA EXPRESS SCRIPTS	7909 S HARDY DR STE 106	TEMPE	AZ	85284-1112	07/14/2022	10/01/2022		10/01/2022
Contract Detail	EXPRESS SCRIPTS	ESI MAIL PHARMACY SERVICE INC	4600 N HANLEY RD	SAINT LOUIS	MO	63134	07/14/2022	10/01/2022		10/01/2022
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	4750 E. 450 S.	WHITESTOWN	IN	46075	07/14/2022	10/01/2022		10/01/2022
Contract Detail	EXPRESS SCRIPTS PHARMACY, INC.	DBA EXPRESS SCRIPTS	2040 ROUTE 130 NORTH	BURLINGTON	NJ	08016	07/14/2022	10/01/2022		10/01/2022
Contract Detail	OPTUM PHARMACY 700, LLC	5700 DOT COM CT, STE 1000		OVIEDO	FL	32765	01/13/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/13/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/13/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/13/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	01/13/2023	04/01/2023		04/01/2023
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	01/13/2023	04/01/2023		04/01/2023
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/13/2023	04/01/2023		04/01/2023
Contract Detail	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	PRIME THERAPEUTICS SPECIALTY PHARMACY LL	ALLIANCERX WALGREENS PRIME #16568	2354 COMMERCE PARK DRIVE SUITE 100	ORLANDO	FL	32819-9992	01/10/2022	04/01/2022	10/01/2022	04/13/2023
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	12/03/2021	01/01/2022		01/01/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY OR CARELONRX SPECIALTY	ONE WATERFRONT PLAZA 500 ALA MOANA BLVD., BLDG 1	HONOLULU	HI	96813	12/03/2021	01/01/2022		01/01/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	12/03/2021	01/01/2022		01/01/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	12/03/2021	01/01/2022		01/01/2022
Contract Detail	PROCARE PHARMACY, L.L.C.	NAVARRO SPECIALTY SERVICES # 10727	7205 CORPORATE CENTER DRIVE SUITE 104	MIAMI	FL	33126	12/03/2021	01/01/2022		01/01/2022
Contract Detail	WALGREEN CO	DBA: WALGREENS #10398	13911 NINE EAGLES DR	TAMPA	FL	33626	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO	DBA: WALGREENS #10398	13911 NINE EAGLES DR	TAMPA	FL	33626	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06293	1505 S BELCHER ROAD	CLEARWATER	FL	33764-7603	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07569	20741 BRUCE B DOWNS BLVD	TAMPA	FL	33647	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02665	3350 CENTRAL AVE	ST PETERSBURG	FL	33712	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06804	5767 38TH AVE N	ST PETERSBURG	FL	33710-1925	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03951	900 49TH STREET N	SAINT PETERSBURG	FL	33710-3371	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 15394	2495 N MCMULLEN BOOTH RD	CLEARWATER	FL	33759	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13631	30280 US HWY 19 NORTH	CLEARWATER	FL	33761	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03046	2295 EAST BAY DRIVE	LARGO	FL	33771	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09517	10196 66TH STREET NORTH	PINELLAS PARK	FL	33782	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #13630	1301 SECOND AVE, S.W. SUITE 200	LARGO	FL	33770	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 15519	10801 ROOSEVELT BLVD NORTH	ST PETERSBURG	FL	33716-3818	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07651	10697 ULMERTON RD	LARGO	FL	33771-3527	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 01339	3077 54TH AVE S	ST PETERSBURG	FL	33712-4613	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02230	5420 DR MARTIN LUTHER KING JR ST N	ST PETERSBURG	FL	33703	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03778	1801 GULF TO BAY BLVD	CLEARWATER	FL	33765	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03794	5701 GULFPORT BLVD S	GULFPORT	FL	33707	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03555	1880 N BELCHER RD	CLEARWATER	FL	33765	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15301	3030 1ST AVE N	ST PETERSBURG	FL	33713	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02918	875 DR MARTIN LUTHER KING JR ST N	SAINT PETERSBURG	FL	33701	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09688	1701 N MCMULLEN BOOTH RD	CLEARWATER	FL	33759-2115	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03795	6996 US HWY 19 N	PINELLAS PARK	FL	33781	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06292	5405 66TH STREET N	ST PETERSBURG	FL	33709-1510	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12885	2495 SANDY POINT RD	PALM HARBOR	FL	34685	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09031	3851 4TH ST NORTH	ST PETERSBURG	FL	33703	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06786	7751 49TH STREET N	PINELLAS PARK	FL	33781	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREEN CO.	WALGREENS #16399	3100 E. FLETCHER AVE SUITE A165	TAMPA	FL	33613	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #21226	1506 W KENNEDY BLVD STE A	TAMPA	FL	33606	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07569	20741 BRUCE B DOWNS BLVD	TAMPA	FL	33647	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 15394	2495 N MCMULLEN BOOTH RD	CLEARWATER	FL	33759	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS #13631	30280 US HWY 19 NORTH	CLEARWATER	FL	33761	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #13630	1301 SECOND AVE, S.W. SUITE 200	LARGO	FL	33770	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05212	4445 US HWY 98 NORTH	LAKELAND	FL	33809	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS #04023	501 HAVENDALE BLVD	AUBURNDALE	FL	33823	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 13797	395 E. VAN FLEET DR	BARTOW	FL	33830	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS #11104	40079 US HIGHWAY 27	DAVENPORT	FL	33837	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04380	1903 STATE ROAD 60 E	LAKE WALES	FL	33853	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS #11190	24170 HWY 27	LAKE WALES	FL	33859	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 04005	705 1ST STREET SOUTH	WINTER HAVEN	FL	33880	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07806	805 HAVENDALE BLVD NW	WINTER HAVEN	FL	33881	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05328	5545 CYPRESS GARDENS BLVD	WINTER HAVEN	FL	33884	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06217	45549 HWY 27	DAVENPORT	FL	33897	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS #12885	2495 SANDY POINT RD	PALM HARBOR	FL	34685	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA WALGREENS SPECIALTY PHARMACY #15301	3030 1ST AVE N	ST PETERSBURG	FL	33713	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05946	93 US HIGHWAY 27 S	AVON PARK	FL	33825	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09031	3851 4TH ST NORTH	ST PETERSBURG	FL	33703	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09509	395 CYPRESS PKWY	KISSIMMEE	FL	34759	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 01339	3077 54TH AVE S	ST PETERSBURG	FL	33712-4613	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02230	5420 DR MARTIN LUTHER KING JR ST N	ST PETERSBURG	FL	33703	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 15519	10801 ROOSEVELT BLVD NORTH	ST PETERSBURG	FL	33716-3818	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02665	3350 CENTRAL AVE	ST PETERSBURG	FL	33712	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 02918	875 DR MARTIN LUTHER KING JR ST N	SAINT PETERSBURG	FL	33701	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03046	2295 EAST BAY DRIVE	LARGO	FL	33771	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03555	1880 N BELCHER RD	CLEARWATER	FL	33765	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03778	1801 GULF TO BAY BLVD	CLEARWATER	FL	33765	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03794	5701 GULFPORT BLVD S	GULFPORT	FL	33707	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03795	6996 US HWY 19 N	PINELLAS PARK	FL	33781	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 03951	900 49TH STREET N	SAINT PETERSBURG	FL	33710-3371	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06292	5405 66TH STREET N	ST PETERSBURG	FL	33709-1510	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06293	1505 S BELCHER ROAD	CLEARWATER	FL	33764-7603	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06786	7751 49TH STREET N	PINELLAS PARK	FL	33781	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 06804	5767 38TH AVE N	ST PETERSBURG	FL	33710-1925	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 07651	10697 ULMERTON RD	LARGO	FL	33771-3527	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09517	10196 66TH STREET NORTH	PINELLAS PARK	FL	33782	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 09688	1701 N MCMULLEN BOOTH RD	CLEARWATER	FL	33759-2115	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS SPECIALTY PHARMACY #12146	1200 KUHL AVE	ORLANDO	FL	32806	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN CO.	DBA: WALGREENS # 05946	93 US HIGHWAY 27 S	AVON PARK	FL	33825	07/15/2022	10/01/2022		10/01/2022
Contract Detail	Walgreens #21395	Walgreens Central Fill #21395	5710 Young Pine Rd	Orlando	FL	32829	04/13/2023	07/01/2023		07/01/2023
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	01/10/2022	04/01/2022		04/01/2022
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	ALLIANCERX WALGREENS PRIME #12314	9775 SW GEMINI DR, STE 1	BEAVERTON	OR	97008	01/10/2022	04/01/2022	01/14/2022	01/14/2022
Contract Detail	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	12/03/2021	01/01/2022	01/06/2022	01/06/2022
Contract Detail	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	01/10/2022	04/01/2022	01/14/2022	01/14/2022

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	5/23/2024 2:41:47 PM	5/9/2025 4:51:26 PM	5/9/2025 4:51 PM
Details	Last Recertification Date	Update	Recertification	5/31/2023 11:44:15 AM	5/23/2024 2:41:47 PM	5/23/2024 2:41 PM
Details	Last Recertification Date	Update	Recertification	5/13/2022 3:32:21 PM	5/31/2023 11:44:15 AM	5/31/2023 11:44 AM
Contacts	Primary Contact	Update	Profile Change Request	Kutner, Jordan Operations and Organizational Development Manager West Central Gastroenterology d.b.a. Gastro Florida 7273470536	Kutner, Jordan Director of Operations West Central Gastroenterology d.b.a. Gastro Florida 7274979152	8/11/2022 2:34 PM
Details	Last Recertification Date	Update	Recertification		5/13/2022 3:32:21 PM	5/13/2022 3:32 PM
Details	State	Update		Approved	Active	1/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Salyani, Seena CEO West Central Gastroenterology dba Gastro Florida 7273470536	12/3/2021 8:21 AM
Details	340B ID	Update	New Registration		STD337051	12/3/2021 8:21 AM
Dates	Participating Approval Date	Update	New Registration		12/3/2021 8:21:12 AM	12/3/2021 8:21 AM
Details	State	Update	New Registration	Pending	Approved	12/3/2021 8:21 AM
Dates	Signed By Date	Update	New Registration		10/11/2021 12:21:20 PM	12/3/2021 8:21 AM
Dates	Start Date	Update	New Registration		1/1/2022 12:00:00 AM	12/3/2021 8:21 AM
Addresses	Main Address	Insert	New Registration		1201 5th Ave N Ste 402 Saint Petersburg, FL 33705	10/4/2021 3:45 PM
Addresses	Billing Address	Insert	New Registration		West Central Gastroenterology dba Gastro Florida 3001 Executive Dr. Ste 130 Clearwater, FL 33762	10/4/2021 3:45 PM
Addresses	Shipping Address	Insert	New Registration		West Central Gastroenterology dba Gastro Florida 3001 Executive Dr. Ste 130 Clearwater, FL 33762	10/4/2021 3:45 PM
Details	Nature of Support: In Kind Support Description	Insert	New Registration		HIV Test Kits, Condoms, Patient Educational Materials	10/4/2021 3:45 PM
Details	Nature Of Support	Insert	New Registration		In-Kind products or services (see note below; must have been purchased with section 318 funds)	10/4/2021 3:45 PM
Details	Nature of Support: Support Received From Date	Insert	New Registration		8/11/2020 12:00:00 AM	10/4/2021 3:45 PM
Details	Nature of Support: Support Received To Date	Insert	New Registration			10/4/2021 3:45 PM
Contacts	Authorizing Official	Insert	New Registration		Salyani, Seena CEO West Central Gastroenterology dba Gastro Florida 7273470536	10/4/2021 3:45 PM
Contacts	Primary Contact	Insert	New Registration		Kutner, Jordan Operations and Organizational Development Manager West Central Gastroenterology d.b.a. Gastro Florida 7273470536	10/4/2021 3:45 PM
Details	Assistance Received From Date	Insert	New Registration			10/4/2021 3:45 PM
Details	Assistance Received To Date	Insert	New Registration			10/4/2021 3:45 PM
Details	Last Recertification Date	Insert	New Registration			10/4/2021 3:45 PM
Details	Grant Number	Insert	New Registration		H25PS005131	10/4/2021 3:45 PM
Details	340B ID	Insert	New Registration			10/4/2021 3:45 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/4/2021 3:45 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/4/2021 3:45 PM
Details	Medicare Provider Number	Insert	New Registration			10/4/2021 3:45 PM
Details	Entity Name	Insert	New Registration		West Central Gastroenterology dba Gastro Florida	10/4/2021 3:45 PM
Details	NOFO Number	Insert	New Registration		PS19-1901	10/4/2021 3:45 PM
Details	Program Code	Insert	New Registration		STD	10/4/2021 3:45 PM
Details	Entity Subname	Insert	New Registration		Gastro Florida Division 7b	10/4/2021 3:45 PM
Dates	Participating Approval Date	Insert	New Registration			10/4/2021 3:45 PM
Details	State	Insert	New Registration		Pending	10/4/2021 3:45 PM
Dates	Registration Date	Insert	New Registration		10/4/2021 3:45:06 PM	10/4/2021 3:45 PM
Dates	Signed By Date	Insert	New Registration			10/4/2021 3:45 PM
Dates	Start Date	Insert	New Registration			10/4/2021 3:45 PM
Terminations	Termination Comments	Insert	New Registration			10/4/2021 3:45 PM
Terminations	Termination Date	Insert	New Registration			10/4/2021 3:45 PM
Terminations	Termination Effective Date	Insert	New Registration			10/4/2021 3:45 PM
Terminations	Termination Reason	Insert	New Registration			10/4/2021 3:45 PM

340B Drug Pricing Program Database

Comments

Medicaid Billing

Shipping Addresses

Contract Pharmacies

History