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WALGREEN CO.
STD328053 Helping Oppressed & Marginalized Communities to Elevate, Inc.
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Covered Entity Details
Entity Name
Helping Oppressed & Marginalized Communities to Elevate, Inc.
Subdivision Name
HOME - C
Type
Sexually Transmitted Diseases
340B ID
STD328053
Entity Address
6909 W Colonial Dr
Orlando, FL 32818
Grant Number
H25PS005131
Participating Start Date
4/1/2022
Last Recertification Date
5/8/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07165
5601 N HIAWASSEE ROAD
ORLANDO, FL 32818
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Preston J Queenan, President
(484) 868-4948
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2023
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