Contract Pharmacy Details

WALGREEN CO.
HV01312E University of Florida

Covered Entity Details

Entity Name

University of Florida

Subdivision Name

University of Florida CARES CMS

Type

Ryan White Part C

340B ID

HV01312E

Entity Address

910 N. Jefferson St.
Jacksonville, FL 32209

Grant Number

H76HA01312

Participating Start Date

7/1/2019

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

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

Pharmacy Comments

Contract Details

Approval Date

10/31/2020

Contract Begin Date

11/10/2020

Carve-In Effective Date

Contract Comments

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

10/31/2020

340B Drug Pricing Program Database