Contract Pharmacy Details

WALGREEN CO.
STD33174 Latinos Salud, Inc.

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

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06416
960 S POWERLINE RD
POMPANO BEACH, FL 33069

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

Stephen Fallon, PhD, Executive Director
(786) 310-3152

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/14/2025

340B Drug Pricing Program Database