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WALGREEN CO.
CH04550S PREMIER COMMUNITY HEALTHCARE GROUP, INC.
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Covered Entity Details
Entity Name
PREMIER COMMUNITY HEALTHCARE GROUP, INC.
Subdivision Name
Premier Community HealthCare Group, Inc. Mobile Dental Bus
Type
HRSA-Funded Health Center
340B ID
CH04550S
Entity Address
7551 Forest Oaks Blvd
Spring Hill, FL 34606-2437
Grant Number
H80CS00101
Participating Start Date
1/1/2022
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07466
14217 US HWY 19
HUDSON, FL 34667-1170
Pharmacy Comments
Contract Details
Approval Date
10/7/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Resnick, CEO
(352) 518-2000 Ext: 9000
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/6/2021
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