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WALGREEN CO.
CH04907Q Community Health Centers Of Pinellas, Inc.
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Covered Entity Details
Entity Name
Community Health Centers Of Pinellas, Inc.
Subdivision Name
Evara Health - Countryside
Type
HRSA-Funded Health Center
340B ID
CH04907Q
Entity Address
26286 US Highway 19 North
B
Clearwater, FL 33761
Grant Number
H80CS00463
Participating Start Date
7/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09517
10196 66TH STREET NORTH
PINELLAS PARK, FL 33782
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Elodie Leigh Dorso, CEO
(727) 824-8100
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2024
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