340B Drug Pricing Program Database

Pharmacy Name

PRIME THERAPEUTICS SPECIALTY PHARMACY LL

Pharmacy Address

ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992

Pharmacy Comments

Approval Date

11/8/2019

Contract Begin Date

1/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/13/2022
Pharmacy closed

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

10/15/2019