Contract Pharmacy Details

WALGREEN CO.
FQHCLA407L Metropolitan Charities, Inc.

Covered Entity Details

Entity Name

Metropolitan Charities, Inc.

Subdivision Name

METRO at Fletcher Avenue

Type

Health Center Program Look-Alike

340B ID

FQHCLA407L

Entity Address

3500 E Fletcher Ave
Suite 302
Tampa, FL 33613-4797

Grant Number

LALCS35348

Participating Start Date

12/21/2023

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09031
3851 4TH ST NORTH
ST PETERSBURG, FL 33703

Pharmacy Comments

Contract Details

Approval Date

12/28/2023

Contract Begin Date

12/28/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230

Contract Pharmacy Representative

Walgreen Co.
Christine Precht, 340B Client Relationship Analysit
(847) 964-6560

Signed By Date

12/28/2023

340B Drug Pricing Program Database