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WALGREEN CO.
STD334032 WHEAT Community Services
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Covered Entity Details
Entity Name
WHEAT Community Services
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD334032
Entity Address
1511 Prosperity Farms Road
Suite 200
Lake Park, FL 33403-2614
Grant Number
NH25PS005131
Participating Start Date
6/16/2021
Last Recertification Date
6/3/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 15640
18410 PINES BLVD
PEMBROKE PINES, FL 33029
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
Regina F Cooper, Director
(954) 661-7227
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2021
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