Contract Pharmacy Details

WALGREENS MAIL SERVICE, INC.
CH0412810 TAMPA FAMILY HEALTH CENTERS, INC.

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

WALGREENS MAIL SERVICE, INC.

Pharmacy Address

8337 S PARK CIRCLE
ORLANDO, FL 32819-9049

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

6/25/2015
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

340B Drug Pricing Program Database