Contract Pharmacy Details

WALGREEN CO.
RWI33316H CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Orlando

Type

Ryan White Part A

340B ID

RWI33316H

Entity Address

1301 W Colonial Drive
Orlando, FL 32804

Grant Number

6 UT8HA33952-01-01

Participating Start Date

4/1/2021

Last Recertification Date

3/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03745
5185 NORTH LANE
ORLANDO, FL 32808

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