Contract Pharmacy Details

WALGREEN CO.
RW400091C University of Florida CARES

Covered Entity Details

Entity Name

University of Florida CARES

Subdivision Name

University of Florida CARES Emerson

Type

Ryan White Part D

340B ID

RW400091C

Entity Address

4555 Emerson St.
Jacksonville, FL 32207

Grant Number

H12HA24824

Participating Start Date

7/1/2019

Last Recertification Date

2/7/2022

Entity Termination Date

1/1/2023

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05690
866 DUNN AVE
JACKSONVILLE, FL 32218

Pharmacy Comments

Contract Details

Approval Date

10/30/2020

Contract Begin Date

11/10/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2023
Covered Entity Terminated

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

10/30/2020

340B Drug Pricing Program Database