Contract Pharmacy Details

WALGREEN CO.
CH045500 PREMIER COMMUNITY HEALTHCARE GROUP, INC.

Covered Entity Details

Entity Name

PREMIER COMMUNITY HEALTHCARE GROUP, INC.

Subdivision Name

Dade City Dental Center

Type

HRSA-Funded Health Center

340B ID

CH045500

Entity Address

37944 Pasco Ave
Dade City, FL 33525-4207

Grant Number

H80CS00101

Participating Start Date

4/1/1998

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05131
10401 LITTLE ROAD
NEW PORT RICHEY, FL 34654

Pharmacy Comments

Contract Details

Approval Date

10/11/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/20/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Joseph Resnick, CEO
(352) 518-2000 Ext: 9000

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/11/2018

340B Drug Pricing Program Database