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WALGREEN CO.
STD329012 SPEKTRUM Health Melbourne
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Covered Entity Details
Entity Name
SPEKTRUM Health Melbourne
Subdivision Name
FDOH Area 7
Type
Sexually Transmitted Diseases
340B ID
STD329012
Entity Address
1920 South Babcock Street
Melbourne, FL 32901
Grant Number
1H25PS005131
Participating Start Date
8/9/2021
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #13451
3401 PGA BLVD STE-110
PALM BEACH GARDENS, FL 33410
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Anthony Knoll, CEO
(407) 454-1363 Ext: 5001
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2021
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