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WALGREEN CO.
RW400091D University of Florida
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Covered Entity Details
Entity Name
University of Florida
Subdivision Name
University of Florida CARES CMS
Type
Ryan White Part D
340B ID
RW400091D
Entity Address
910 N. Jefferson Street
Jacksonville, FL 32209
Grant Number
H12HA24824
Participating Start Date
8/10/2020
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07257
6103 FT CAROLINE RD
JACKSONVILLE, FL 32277-2035
Pharmacy Comments
Contract Details
Approval Date
10/28/2020
Contract Begin Date
11/10/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/19/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Tina M. Bottini, Senior Asst. Dean, Research
(904) 244-9478
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/28/2020
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