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WALGREEN CO
RRC100062-00 AdventHealth Ocala
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Covered Entity Details
Entity Name
AdventHealth Ocala
Subdivision Name
Type
Rural Referral Center
340B ID
RRC100062-00
Entity Address
1500 SW 1st Ave
Ocala, FL 34471
Medicare Provider Number
100062
Participating Start Date
7/1/2019
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11991
89 MIDWAY RD
OCALA, FL 34472
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Frances H Crunk, CFO
(352) 401-8498
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2020
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