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WALGREEN CO.
STD336053 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD336053
Entity Address
2105 N Nebraska Ave
Tampa, FL 33602-2558
Grant Number
NU62PS924698
Participating Start Date
5/15/2023
Last Recertification Date
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09031
3851 4TH ST NORTH
ST PETERSBURG, FL 33703
Pharmacy Comments
Contract Details
Approval Date
5/15/2023
Contract Begin Date
6/12/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/11/2023
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