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WALGREENS MAIL SERVICE, LLC
CH04023M Agape Community Health Center, Inc.
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Covered Entity Details
Entity Name
Agape Community Health Center, Inc.
Subdivision Name
Agape Dunn Avenue
Type
HRSA-Funded Health Center
340B ID
CH04023M
Entity Address
1680 Dunn Ave Unit 35-37
Jacksonville, FL 32218-4782
Grant Number
H80CS29456
Participating Start Date
10/1/2020
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREENS MAIL SERVICE, LLC
Pharmacy Address
WALGREENS MAIL SERVICE #03397
8350 S RIVER PARKWAY
TEMPE, AZ 85284
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tabatha Ball, COO
(904) 760-4904
Contract Pharmacy Representative
Walgreens
Karl Mechan, Vice President Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2021
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