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WALGREEN CO.
HV01312F University of Florida
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Covered Entity Details
Entity Name
University of Florida
Subdivision Name
UF Health Family Medicine-Commonwealth
Type
Ryan White Part C
340B ID
HV01312F
Entity Address
761 Edgewood Ave N
Jacksonville, FL 32254
Grant Number
H76HA01312
Participating Start Date
10/1/2023
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07257
6103 FT CAROLINE RD
JACKSONVILLE, FL 32277-2035
Pharmacy Comments
Contract Details
Approval Date
8/1/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/19/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Tina M. Bottini, Senior Asst. Dean, Research
(904) 244-9478
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/11/2023
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