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WALGREEN CO.
CH04038Y NORTH FLORIDA MEDICAL CENTERS, INC.
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Covered Entity Details
Entity Name
NORTH FLORIDA MEDICAL CENTERS, INC.
Subdivision Name
Crestview Health Center
Type
HRSA-Funded Health Center
340B ID
CH04038Y
Entity Address
800 Hospital Dr
Crestview, FL 32539
Grant Number
H80CS00693
Participating Start Date
4/1/2008
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06811
2350 S FERDON BLVD
CRESTVIEW, FL 32536-8461
Pharmacy Comments
Contract Details
Approval Date
5/16/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tori Wiggins, CFO
(850) 298-6040
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
5/16/2024
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