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WALGREEN CO.
STD333341 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Dixie Hwy
Type
Sexually Transmitted Diseases
340B ID
STD333341
Entity Address
5333 N. Dixie Hwy
Suite 110
Fort Lauderdale, FL 33334
Grant Number
1 NH25PS005131-01-00
Participating Start Date
1/1/2018
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #21155
5966 S DIXIE HWY STE 103B
SOUTH MIAMI, FL 33143
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0134 Ext: 11111
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2021
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