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WALGREEN CO.
RWII342371H CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
FWB
Type
Ryan White Part B
340B ID
RWII342371H
Entity Address
1825 Hurlburt Rd
Suite 14
Fort Walton Beach, FL 32547
Grant Number
X07HA00057
Participating Start Date
1/1/2020
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09914
1103 US HIGHWAY 331 SOUTH
DEFUNIAK SPRINGS, FL 32435-3383
Pharmacy Comments
Contract Details
Approval Date
7/27/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rishi Patel, President & CEO
(941) 300-4440 Ext: 11127
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/27/2024
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