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WALGREEN CO.
CH041700 COLLIER HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
COLLIER HEALTH SERVICES, INC.
Subdivision Name
COLLIER HEALTH SERVICES, INC.
Type
HRSA-Funded Health Center
340B ID
CH041700
Entity Address
1454 Madison Ave W
Immokalee, FL 34142-2200
Grant Number
H80CS00735
Participating Start Date
12/1/1992
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #04958
7985 AIRPORT RD N
NAPLES, FL 34109
Pharmacy Comments
Contract Details
Approval Date
1/11/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mike Ellis, President/CEO
(239) 658-3158
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/11/2017
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