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Walgreens #21395
CHC26803-01 Neighborhood Medical Center Inc.
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Covered Entity Details
Entity Name
Neighborhood Medical Center Inc.
Subdivision Name
Neighborhood Medical Center Smith Williams Center
Type
HRSA-Funded Health Center
340B ID
CHC26803-01
Entity Address
2295 PASCO ST
TALLAHASSEE, FL 32310-0908
Grant Number
H80CS26803
Participating Start Date
7/1/2014
Last Recertification Date
3/7/2025
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
10/14/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeanne S Freeman, CEO
(850) 577-1558
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/14/2022
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