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WALGREEN CO.
CH0413190 TREASURE COAST COMMUNITY HEALTH INC
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Covered Entity Details
Entity Name
TREASURE COAST COMMUNITY HEALTH INC
Subdivision Name
TREASURE COAST COMMUNITY HEALTH, INC. South County
Type
HRSA-Funded Health Center
340B ID
CH0413190
Entity Address
1545 9th St. SW
Vero Beach, FL 32962-4312
Grant Number
H80CS00187
Participating Start Date
7/1/2000
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06487
3495 BAYSIDE LAKES BLVD SE
PALM BAY, FL 32909
Pharmacy Comments
Contract Details
Approval Date
1/15/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
VICKI L. SOULE, CEO
(772) 571-1986
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2016
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