340B Drug Pricing Program Database
WALGREEN CO.
STD33150 I&B Medical Associates PLLC - information as of 6/5/2025 3:01:32 PM
Covered Entity Details
Entity Name
I&B Medical Associates PLLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33150
Entity Address
9400 NW 12 Ave.
Ste. 1
Miami, FL 33150
Grant Number
NH25PS005131
Participating Start Date
7/1/2018
Last Recertification Date
5/8/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03782
5701 NW 183RD ST
HIALEAH, FL 33015
Pharmacy Comments
Contract Details
Approval Date
4/1/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Etzer Dolce, Director of Operations
(516) 850-9127
Contract Pharmacy Representative
Walgreens
Ruthann Archer, Director of 340B Operations
(847) 964-8116
Signed By Date
4/1/2025
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