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Walgreens #21395
STD33174 Latinos Salud, Inc.
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Covered Entity Details
Entity Name
Latinos Salud, Inc.
Subdivision Name
Miami Southwest
Type
Sexually Transmitted Diseases
340B ID
STD33174
Entity Address
8946 SW 40th St
Miami, FL 33165
Grant Number
5 NU62PS924749-02-00
Participating Start Date
10/1/2020
Last Recertification Date
5/6/2024
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
4/1/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen Fallon, PhD, Executive Director
(786) 310-3152
Contract Pharmacy Representative
walgreens
pamela vlahopoulos, Senior Analyst, 340B Client Relationship
(847) 964-7780
Signed By Date
4/1/2025
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