Contract Pharmacy Details

Walgreens #21395
RWI33136A University of Miami

Covered Entity Details

Entity Name

University of Miami

Subdivision Name

Pathway to Wellness Clinic

Type

Ryan White Part A

340B ID

RWI33136A

Entity Address

1120 NW 14th St
860
Miami, FL 33136

Grant Number

H89HA00005

Participating Start Date

1/1/2024

Last Recertification Date

2/20/2025

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

11/6/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Hansel Tookes, Assistant Professor of Clinical Medicine
(305) 243-1615

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

10/3/2023

340B Drug Pricing Program Database