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WALGREEN CO
CH04271D TRENTON MEDICAL CENTER
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Covered Entity Details
Entity Name
TRENTON MEDICAL CENTER
Subdivision Name
Palms Medical Group - Williston
Type
HRSA-Funded Health Center
340B ID
CH04271D
Entity Address
630 N Main St
Williston, FL 32696-1705
Grant Number
H80CS00691
Participating Start Date
1/1/2010
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11306
8 NW MAIN ST
WILLISTON, FL 32696
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
Anita Rembert, CEO
(352) 463-4501
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/16/2024
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