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WALGREEN CO
STD344715 Positive Assistance, Inc.
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Covered Entity Details
Entity Name
Positive Assistance, Inc.
Subdivision Name
Infectious Diseases Associates Of North Central Florida, LLC
Type
Sexually Transmitted Diseases
340B ID
STD344715
Entity Address
3306 SW 26th Ave
Suite 104
Ocala, FL 34471
Grant Number
5NU62PS924532-02
Participating Start Date
1/1/2022
Last Recertification Date
5/15/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
WALGREENS #10373
2235 PARR DRIVE
LADY LAKE, FL 32162-5381
Pharmacy Comments
Contract Details
Approval Date
1/10/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Andre J Antenor, President
(863) 242-3322
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/10/2023
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