Contract Pharmacy Details

WALGREEN CO.
FQHCLA407G Metropolitan Charities, Inc.

Covered Entity Details

Entity Name

Metropolitan Charities, Inc.

Subdivision Name

METRO North St. Pete

Type

Health Center Program Look-Alike

340B ID

FQHCLA407G

Entity Address

11201 Corporate Cir N, Ste 140
Saint Petersburg, FL 33716-3701

Grant Number

LALCS35348

Participating Start Date

10/16/2023

Last Recertification Date

2/21/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #16399
3100 E. FLETCHER AVE
SUITE A165
TAMPA, FL 33613

Pharmacy Comments

Contract Details

Approval Date

4/4/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Priya Rajkumar, Chief Executive Officer
(727) 321-3854 Ext: 1230

Contract Pharmacy Representative

Walgreen Co.
Christine Precht, 340B Client Relationship Analysit
(847) 964-6560

Signed By Date

4/4/2024

340B Drug Pricing Program Database