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WALGREEN CO.
CH040250 PROJECT HEALTH, INC
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Covered Entity Details
Entity Name
PROJECT HEALTH, INC
Subdivision Name
THOMAS E. LANGLEY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH040250
Entity Address
1389 SOUTH US HIGHWAY 301
SUMTERVILLE, FL 33585
Grant Number
H80CS00412
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05578
11283 N WILLIAMS ST
DUNNELLON, FL 34432
Pharmacy Comments
Contract Details
Approval Date
1/7/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John M. Sivon, Chief Strategy Officer
(352) 569-2386
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/7/2022
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