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WALGREEN CO.
STD333083 Light of Hope, Inc.
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Covered Entity Details
Entity Name
Light of Hope, Inc.
Subdivision Name
Light of Hope 2
Type
Sexually Transmitted Diseases
340B ID
STD333083
Entity Address
2021 E Commercial Blvd.
205
Fort Lauderdale, FL 33308
Grant Number
NH25PS004342
Participating Start Date
1/1/2024
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #21246
168 N POWERLINE RD STE 200
POMPANO BEACH, FL 33069
Pharmacy Comments
Contract Details
Approval Date
1/9/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristin Renae, Vice President
(954) 776-9992
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/9/2024
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