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WALGREEN CO
CH040210 CENTRAL FLORIDA HEALTH CARE, INC.
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Covered Entity Details
Entity Name
CENTRAL FLORIDA HEALTH CARE, INC.
Subdivision Name
CFHC Avon Park Primary Care
Type
HRSA-Funded Health Center
340B ID
CH040210
Entity Address
950 COUNTY ROAD 17-A, WEST
AVON PARK, FL 33825-2164
Grant Number
H80CS00423
Participating Start Date
1/1/2000
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #09098
2 US 27 S
LAKE PLACID, FL 33852
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/15/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
ANN CLAUSSEN, CEO
(863) 291-5115
Contract Pharmacy Representative
Central Florida Health Care
Ron M Pickos, Chief Pharmacy Officer
(863) 206-3710
Signed By Date
10/12/2018
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