Contract Pharmacy Details

WALGREEN CO.
CH04168D FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.

Covered Entity Details

Entity Name

FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA, INC.

Subdivision Name

FORT MYERS CENTER - DOWNTOWN

Type

HRSA-Funded Health Center

340B ID

CH04168D

Entity Address

2232 GRAND AVE
FORT MYERS, FL 33901-3717

Grant Number

H80CS00185

Participating Start Date

4/1/1995

Last Recertification Date

3/4/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06164
15180 TAMIAMI TRAILS
NORTH PORT, FL 34287

Pharmacy Comments

Contract Details

Approval Date

4/13/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Frank Mazzeo Jr., CEO
(239) 278-3600

Contract Pharmacy Representative

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

Signed By Date

4/13/2017

340B Drug Pricing Program Database