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WALGREEN CO.
STD33150 I&B Medical Associates PLLC
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Covered Entity Details
Entity Name
I&B Medical Associates PLLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33150
Entity Address
9400 NW 12 Ave.
Ste. 1
Miami, FL 33150
Grant Number
NH25PS005131
Participating Start Date
7/1/2018
Last Recertification Date
5/8/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03493
9498 NW 7TH AVE
MIAMI, FL 33150
Pharmacy Comments
Contract Details
Approval Date
1/16/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/8/2025
Ownership change
Contacts
Covered Entity Signing Official
Lisa Barr, Executive Director
(407) 645-2577 Ext: 121
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/16/2019
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