Contract Pharmacy Details

WALGREEN CO.
FQHCLA407D Metropolitan Charities, Inc.

Covered Entity Details

Entity Name

Metropolitan Charities, Inc.

Subdivision Name

METRO Central

Type

Health Center Program Look-Alike

340B ID

FQHCLA407D

Entity Address

2237 Central Ave
Saint Petersburg, FL 33713-8844

Grant Number

LALCS35348

Participating Start Date

8/4/2021

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09031
3851 4TH ST NORTH
ST PETERSBURG, FL 33703

Pharmacy Comments

Contract Details

Approval Date

8/4/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

8/3/2021

340B Drug Pricing Program Database