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WALGREEN CO.
STD33169 ALIVE and WELL COMMUNITY PARTNERS
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Covered Entity Details
Entity Name
ALIVE and WELL COMMUNITY PARTNERS
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33169
Entity Address
18425 N.W. 2ND AVENUE
5TH FLOOR
PH-7
MIAMI, FL 33169
Grant Number
NH25PS005131
Participating Start Date
1/1/2020
Last Recertification Date
5/25/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15912
7100 W 20TH AVENUE, STE G177
HIALEAH, FL 33016
Pharmacy Comments
Contract Details
Approval Date
10/19/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/22/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Steve Taylor, CFO/OPERATIONS OFFICER
(800) 434-1366 Ext: 1000
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/19/2021
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