Contract Pharmacy Details

WALGREEN CO.
STD33460 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Lake Worth

Type

Sexually Transmitted Diseases

340B ID

STD33460

Entity Address

201 N. Dixie Highway
Lake Worth, FL 33460

Grant Number

6 NH25PS005131-02-02

Participating Start Date

4/1/2021

Last Recertification Date

5/28/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05174
105 E OCEAN AVE
LANTANA, FL 33462

Pharmacy Comments

Contract Details

Approval Date

4/15/2021

Contract Begin Date

7/1/2021

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

4/15/2021

340B Drug Pricing Program Database