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Walgreens #21395
STD323011 big bend cares
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Covered Entity Details
Entity Name
big bend cares
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD323011
Entity Address
2200 S Monroe St
Tallahassee, FL 32301
Grant Number
6 NH25PS005131-05-04
Participating Start Date
1/1/2017
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
Walgreens #21395
Pharmacy Address
Walgreens Central Fill #21395
5710 Young Pine Rd
Orlando, FL 32829
Pharmacy Comments
Contract Details
Approval Date
10/6/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Renzi, CEO
(850) 656-2437 Ext: 240
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/6/2022
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