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Walgreens #21395
CHC12859 HEART OF FLORIDA HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
HEART OF FLORIDA HEALTH CENTER, INC.
Subdivision Name
Heart of Florida Health Center
Type
HRSA-Funded Health Center
340B ID
CHC12859
Entity Address
1025 SW 1st Avenue
Ocala, FL 34471-0900
Grant Number
H80CS12859
Participating Start Date
10/1/2011
Last Recertification Date
2/12/2025
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
7/12/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matt Clay, CEO
(352) 433-2867
Contract Pharmacy Representative
Walgreens
Nicole Cassell, Senior Analyst
(847) 315-4650
Signed By Date
7/12/2023
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