Contract Pharmacy Details

WALGREEN CO.
CH0412810 TAMPA FAMILY HEALTH CENTERS, INC.

Covered Entity Details

Entity Name

TAMPA FAMILY HEALTH CENTERS, INC.

Subdivision Name

TFHC #16 New Nebraska

Type

HRSA-Funded Health Center

340B ID

CH0412810

Entity Address

12410 N Nebraska Ave
Tampa, FL 33612

Grant Number

H80CS00407

Participating Start Date

7/1/1995

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04480
3770 TAMPA ROAD
OLDSMAR, FL 34677

Pharmacy Comments

Contract Details

Approval Date

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Sherry Hoback, Chief Executive Officer
(813) 866-0930 Ext: 1319

Contract Pharmacy Representative

Tampa Family Health Centers, Inc.
Jeffrey Parrado, Chief Pharmacy Officer
(813) 866-0930 Ext: 1363

Signed By Date

1/15/2020

340B Drug Pricing Program Database