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WALGREEN CO
STD33815 Pineapple Healthcare Inc.
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Covered Entity Details
Entity Name
Pineapple Healthcare Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33815
Entity Address
1253 W Memorial Blvd
Lakeland, FL 33815
Grant Number
NH25PS005131
Participating Start Date
10/1/2024
Last Recertification Date
5/5/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #10556
5903 S ORANGE BLOSSOM TRAIL
ORLANDO, FL 32809
Pharmacy Comments
Contract Details
Approval Date
8/7/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ethan Michael Suarez, President
(407) 839-7278
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/11/2024
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