Contract Pharmacy Details

WALGREEN CO.
STD342871 CAN Community Health, Inc.

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

NU62PS924532

Participating Start Date

4/5/2019

Last Recertification Date

5/28/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #15299
1201 NE 26TH ST STE 110
WILTON MANORS, FL 33305

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