Contract Pharmacy Details

WALGREEN CO.
RWII34287 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

North Port

Type

Ryan White Part B

340B ID

RWII34287

Entity Address

14243 Tamiami Trail
North Port, FL 34287

Grant Number

X07HA00057

Participating Start Date

1/1/2014

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06164
15180 TAMIAMI TRAILS
NORTH PORT, FL 34287

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