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WALGREEN CO.
CH0412810 TAMPA FAMILY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
TAMPA FAMILY HEALTH CENTERS, INC.
Subdivision Name
TFHC #16 New Nebraska
Type
HRSA-Funded Health Center
340B ID
CH0412810
Entity Address
12410 N Nebraska Ave
Tampa, FL 33612
Grant Number
H80CS00407
Participating Start Date
7/1/1995
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04326
4319 N. ARMENIA AVE.
TAMPA, FL 33607
Pharmacy Comments
Contract Details
Approval Date
12/21/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/18/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CHARLES R. BOTTOMS, CEO
(813) 866-0930
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
12/21/2012
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