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WALGREEN CO.
STD347444 Sunshine Specialty Health Outreach Foundation
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Covered Entity Details
Entity Name
Sunshine Specialty Health Outreach Foundation
Subdivision Name
Gastroenterology and Nutrition
Type
Sexually Transmitted Diseases
340B ID
STD347444
Entity Address
901 E Oak Street
Suite C
Kissimmee, FL 34744
Grant Number
5NU62PS9224532-02
Participating Start Date
4/1/2023
Last Recertification Date
5/7/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03650
2420 E COLONIAL DRIVE
ORLANDO, FL 32803
Pharmacy Comments
Contract Details
Approval Date
7/6/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jillian Hall, CEO
(407) 888-5980
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/6/2023
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