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WALGREEN CO.
STD33125 Florida Department of Health
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Covered Entity Details
Entity Name
Florida Department of Health
Subdivision Name
DADE County Health Department - STD PREP- West Dade Clinic
Type
Sexually Transmitted Diseases
340B ID
STD33125
Entity Address
11865 S.W. 26 Street Suite #J2
Miami, FL 33175
Grant Number
6NH25PS005131
Participating Start Date
4/1/2015
Last Recertification Date
5/13/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #21155
5966 S DIXIE HWY STE 103B
SOUTH MIAMI, FL 33143
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maribel A Zayas, Chief Financial Officer
(786) 845-0137
Contract Pharmacy Representative
Walgreens
Ruthann Archer, Director of 340B Operations
(847) 964-8116
Signed By Date
4/15/2025
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