Contract Pharmacy Details

WALGREEN CO.
FQHCLA356A Whole Family Health Center, Inc.

Covered Entity Details

Entity Name

Whole Family Health Center, Inc.

Subdivision Name

Whole Family Health Center

Type

Health Center Program Look-Alike

340B ID

FQHCLA356A

Entity Address

981 37th Place
Vero Beach, FL 32960-6541

Grant Number

LALCS31468

Participating Start Date

10/24/2017

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04391
2501 VIRGINIA AVE.
FT PIERCE, FL 34981

Pharmacy Comments

Contract Details

Approval Date

7/13/2020

Contract Begin Date

7/14/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/9/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Marie Andress, CEO
(772) 925-8200

Contract Pharmacy Representative

Whole Family Health Center
Jamie Lynnette Merritt, Vice President
(772) 925-8200 Ext: 104

Signed By Date

7/13/2020

340B Drug Pricing Program Database