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Walgreens #21395
FQHCLA407 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
METRO Clearwater
Type
Health Center Program Look-Alike
340B ID
FQHCLA407
Entity Address
18167 US Highway 19 North
Suite 150
Clearwater, FL 33764-6566
Grant Number
LALCS35348
Participating Start Date
4/14/2020
Last Recertification Date
2/21/2025
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
1/5/2024
Contract Begin Date
4/1/2024
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
1/5/2024
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