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WALGREEN CO.
STD336173 Midway Specialty Care Center Inc
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Covered Entity Details
Entity Name
Midway Specialty Care Center Inc
Subdivision Name
Sexually Transmitted Diseases
Type
Sexually Transmitted Diseases
340B ID
STD336173
Entity Address
11454 N 53rd Street
Temple Terrace, FL 33617
Grant Number
NH25PS005131
Participating Start Date
4/1/2022
Last Recertification Date
5/12/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03247
2075 US HWY 1 SOUTH
ST AUGUSTINE, FL 32086
Pharmacy Comments
Contract Details
Approval Date
4/14/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathryn E Hayden, CFO
(772) 742-9276
Contract Pharmacy Representative
Walgreens
Ruthann Archer, Director of 340B Operations
(847) 964-8116
Signed By Date
4/14/2025
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