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Walgreens #21395
CH042400 CAMILLUS HEALTH CONCERN INC
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Covered Entity Details
Entity Name
CAMILLUS HEALTH CONCERN INC
Subdivision Name
CAMILLUS HEALTH CONCERN, INC.
Type
HRSA-Funded Health Center
340B ID
CH042400
Entity Address
336 NW 5th St
Miami, FL 33128-1616
Grant Number
H80CS00026
Participating Start Date
7/1/1995
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
Walgreens #21395
Pharmacy Address
Walgreens Central Fill #21395
5710 Young Pine Rd
Orlando, FL 32829
Pharmacy Comments
Contract Details
Approval Date
10/14/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Francis Afram-Gyening, CEO
(216) 924-0385
Contract Pharmacy Representative
Walgreens
Joyce Abraham, Analyst, 340B Client Relationship
(847) 964-6382
Signed By Date
10/14/2024
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