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Walgreens #21395
STD32514 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Gulf Coast
Type
Sexually Transmitted Diseases
340B ID
STD32514
Entity Address
2120 E. Johnson Ave.
Suite 105
Pensacola, FL 32514
Grant Number
1 NH25PS005131-01-00
Participating Start Date
7/1/2022
Last Recertification Date
5/27/2024
Entity Termination Date
7/1/2024
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
10/15/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2022
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