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WALGREEN CO.
FQHCLA407G Metropolitan Charities, Inc.
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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
DBA WALGREENS SPECIALTY PHARMACY #21155
5966 S DIXIE HWY STE 103B
SOUTH MIAMI, FL 33143
Pharmacy Comments
Contract Details
Approval Date
7/3/2024
Contract Begin Date
10/1/2024
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
7/3/2024
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