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Walgreens #21395
RWII32301A Big Bend Cares
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Covered Entity Details
Entity Name
Big Bend Cares
Subdivision Name
Type
Ryan White Part B
340B ID
RWII32301A
Entity Address
2200 S. Monroe St
Tallahassee, FL 32301
Grant Number
X07HA00057
Participating Start Date
1/1/2017
Last Recertification Date
2/10/2025
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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