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Walgreens #21395
STD337053 Love the Golden Rule, Inc.
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Covered Entity Details
Entity Name
Love the Golden Rule, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD337053
Entity Address
1525 16th Street South
Suite1
Saint Petersburg, FL 33705
Grant Number
NH25PS005131
Participating Start Date
8/18/2023
Last Recertification Date
5/20/2024
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
1/15/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert J Wallace, Medical Director
(727) 826-0700
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/15/2024
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