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WALGREEN CO.
STD334621 Midway Specialty Care Center
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Covered Entity Details
Entity Name
Midway Specialty Care Center
Subdivision Name
Sexually Transmitted Diseases
Type
Sexually Transmitted Diseases
340B ID
STD334621
Entity Address
5507 South Congress Ave
150
Atlantis, FL 33462
Grant Number
NH25PS005131
Participating Start Date
10/1/2022
Last Recertification Date
5/8/2025
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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