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WALGREENS SPECIALTY PHARMACY, LLC
STD33334 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Oakland Park
Type
Sexually Transmitted Diseases
340B ID
STD33334
Entity Address
1421 E Oakland Park Blvd
Suite 200
Fort Lauderdale, FL 33334
Grant Number
1 NH25PS005131-01-00
Participating Start Date
7/1/2017
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2019
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