340B Drug Pricing Program Database

Pharmacy Name

PRIME THERAPEUTICS SPECIALTY PHARMACY LL

Pharmacy Address

ALLIANCERX WALGREENS PRIME #16568
2354 COMMERCE PARK DRIVE
SUITE 100
ORLANDO, FL 32819-9992

Pharmacy Comments

Approval Date

1/11/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/13/2022
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Dave Dellitt, Chief Financial Officer
(309) 779-2218

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/11/2021