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WALGREENS MAIL SERVICE, LLC
CH04023L AGAPE COMMUNITY HEALTH CENTER South
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Covered Entity Details
Entity Name
AGAPE COMMUNITY HEALTH CENTER South
Subdivision Name
Agape Community Health Center, Inc
Type
HRSA-Funded Health Center
340B ID
CH04023L
Entity Address
3900 University Blvd S
Jacksonville, FL 32216-4395
Grant Number
H80CS29456
Participating Start Date
4/1/2017
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, LLC
Pharmacy Address
WALGREENS MAIL SERVICE #03397
8350 S RIVER PARKWAY
TEMPE, AZ 85284
Pharmacy Comments
Contract Details
Approval Date
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tabatha Ball, COO
(904) 760-4904
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/14/2019
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