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WALGREEN CO.
STD33884 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
STD33884
Entity Address
280 Patterson Road
Suite 3
Haines City, FL 33844
Grant Number
NH25PS005131
Participating Start Date
7/1/2020
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #13849
2540 NE 15TH AVE
WILTON MANORS, FL 33305
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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