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WALGREEN CO.
STD34652 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
NPR
Type
Sexually Transmitted Diseases
340B ID
STD34652
Entity Address
4758 Rowan Road
New Port Richey, FL 34653
Grant Number
1 NH25PS005131-01-00
Participating Start Date
10/1/2017
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06751
514 E WINDHORST ROAD
BRANDON, FL 33510-2532
Pharmacy Comments
Contract Details
Approval Date
7/15/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0461 Ext: 11111
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2018
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