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WALGREEN CO.
FQHCLA453 Florida Atlantic University
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Covered Entity Details
Entity Name
Florida Atlantic University
Subdivision Name
FAU/NCHA Westgate Community Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA453
Entity Address
1650 Osceola Dr
West Palm Beach, FL 33409-5038
Grant Number
LALCS41899
Participating Start Date
1/1/2024
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 16388
4560 OKEECHOBEE BLVD
WEST PALM BEACH, FL 33417
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karethy Ann Edwards, CEO
(561) 334-3751
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/16/2024
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