Contract Pharmacy Details

WALGREEN CO.
STD337102 West Central Gastroenterology dba Gastro Florida

Covered Entity Details

Entity Name

West Central Gastroenterology dba Gastro Florida

Subdivision Name

Gastro Florida Division 3

Type

Sexually Transmitted Diseases

340B ID

STD337102

Entity Address

7017 Central Ave.
Saint Petersburg, FL 33710

Grant Number

H25PS005131

Participating Start Date

1/1/2022

Last Recertification Date

5/23/2024

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

1/10/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/14/2022
Agreement registered in error

Contacts

Covered Entity Signing Official

Seena Salyani, CEO
(727) 347-0536

Contract Pharmacy Representative

Walgreens
Chris Sutter, Account Manager, Health Systems
(847) 612-0296

Signed By Date

1/10/2022

340B Drug Pricing Program Database