340B Drug Pricing Program Database
WALGREEN CO.
CH043823M BREVARD HEALTH ALLIANCE INC., THE - information as of 6/13/2025 3:19:02 PM
Covered Entity Details
Entity Name
BREVARD HEALTH ALLIANCE INC., THE
Subdivision Name
BHA Sarno Regional Clinic
Type
HRSA-Funded Health Center
340B ID
CH043823M
Entity Address
2120 Sarno Road, Ste 2120
Melbourne, FL 32935
Grant Number
H80CS04213
Participating Start Date
7/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06487
3495 BAYSIDE LAKES BLVD SE
PALM BAY, FL 32909
Pharmacy Comments
Contract Details
Approval Date
4/11/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Austin Helton, CEO
(321) 241-6868
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/11/2019
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