Contract Pharmacy Details

WALGREEN CO.
CH04170L COLLIER HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

COLLIER HEALTH SERVICES, INC.

Subdivision Name

Countryside Dental

Type

HRSA-Funded Health Center

340B ID

CH04170L

Entity Address

1749 Heritage Trail
801
Naples, FL 34112

Grant Number

H80CS00735

Participating Start Date

10/1/2015

Last Recertification Date

2/18/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04524
12780 TAMIAMI TRAIL E
NAPLES, FL 34113

Pharmacy Comments

Contract Details

Approval Date

10/11/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

John Fletcher, Chief Operating Officer & General Counsel
(239) 658-3060

Contract Pharmacy Representative

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

Signed By Date

10/11/2023

340B Drug Pricing Program Database