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WALGREEN CO.
STD338371 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD338371
Entity Address
42733 US Hwy 27
Suite 201
Davenport, FL 33837
Grant Number
NH25PS005131
Participating Start Date
10/1/2024
Last Recertification Date
Entity Termination Date
7/1/2025
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
8/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
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
7/10/2024
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