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WALGREEN CO.
DSH100086 BROWARD HEALTH NORTH
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Covered Entity Details
Entity Name
BROWARD HEALTH NORTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100086
Entity Address
201 EAST SAMPLE ROAD
DEERFIELD BEACH, FL 33064
Medicare Provider Number
100086
Participating Start Date
7/1/2022
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 01139
1325 S MILITARY TRAIL
DEERFIELD BEACH, FL 33442
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joshua Szostek, CFO
(954) 786-4554
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2022
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