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Walgreens #21395
STD33137 Care Resource Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Care Resource Community Health Centers, Inc.
Subdivision Name
Care Resource
Type
Sexually Transmitted Diseases
340B ID
STD33137
Entity Address
3510 Biscayne blvd
Miami, FL 33137
Grant Number
NU62PS924532
Participating Start Date
1/1/2024
Last Recertification Date
Entity Termination Date
7/1/2024
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
11/29/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Keri Kratofil, Chief Executive Officer
(305) 576-1234 Ext: 157
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2023
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