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WALGREEN CO.
STD342871 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
North Port
Type
Sexually Transmitted Diseases
340B ID
STD342871
Entity Address
14243 Tamiami Trail
North Port, FL 34287
Grant Number
1 NH25PS005131-01-00
Participating Start Date
4/5/2019
Last Recertification Date
5/27/2024
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
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