Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
RWII34982A Midway Specialty Care Center Inc

Covered Entity Details

Entity Name

Midway Specialty Care Center Inc

Subdivision Name

Type

Ryan White Part B

340B ID

RWII34982A

Entity Address

113 NE 19TH DRIVE
OKEECHOBEE, FL 34972

Grant Number

X07HA00057

Participating Start Date

10/1/2018

Last Recertification Date

1/28/2020

Entity Termination Date

1/1/2021

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

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2021
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Kathryn E Hayden, CFO
(772) 742-9276

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/15/2020

340B Drug Pricing Program Database