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WALGREEN CO.
STD331362 University of Miami PrEP Clinic
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Covered Entity Details
Entity Name
University of Miami PrEP Clinic
Subdivision Name
Mobile Wellness Unit
Type
Sexually Transmitted Diseases
340B ID
STD331362
Entity Address
1951 NW 7th avenue
480
Miami, FL 33136
Grant Number
6-NU62PS924532-03-02
Participating Start Date
10/1/2018
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12260
11700 SW 104TH ST
MIAMI, FL 33186
Pharmacy Comments
Contract Details
Approval Date
8/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/19/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Susanne Doblecki-Lewis, Professor of Clinical Medicine and Chief, Division of Infectious Diseases
(305) 243-7652
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/26/2018
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