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WALGREEN CO.
STD32714 Community Care Resources Inc
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Covered Entity Details
Entity Name
Community Care Resources Inc
Subdivision Name
Community Care Resources of FL
Type
Sexually Transmitted Diseases
340B ID
STD32714
Entity Address
106 Boston Avenue
Suite 204
Altamonte Springs, FL 32701
Grant Number
NH25PS005131
Participating Start Date
4/1/2020
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS SPECIALTY PHARMACY #12146
1200 KUHL AVE
ORLANDO, FL 32806
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
4/23/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Victoria Barnhart, Director
(954) 362-5432
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2021
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