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WALGREEN CO.
DSH100039 BROWARD HEALTH MEDICAL CENTER
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Covered Entity Details
Entity Name
BROWARD HEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100039
Entity Address
1600 SOUTH ANDREWS AVE.
FORT LAUDERDALE, FL 33316
Medicare Provider Number
100039
Participating Start Date
7/1/2003
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15299
1201 NE 26TH ST STE 110
WILTON MANORS, FL 33305
Pharmacy Comments
Contract Details
Approval Date
10/16/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laura Danielle Thomas, CFO
(954) 767-5471
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2020
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