Contract Pharmacy Details

WALGREEN CO.
CH040310 BORINQUEN HEALTH CARE CENTER INC

Covered Entity Details

Entity Name

BORINQUEN HEALTH CARE CENTER INC

Subdivision Name

BMC Emilio Lopez Pavilion (Main Site)

Type

HRSA-Funded Health Center

340B ID

CH040310

Entity Address

3601 Federal Hwy
Miami, FL 33137-3795

Grant Number

H80CS00618

Participating Start Date

4/1/1996

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04728
6200 NW 7TH AVE
MIAMI, FL 33150

Pharmacy Comments

Contract Details

Approval Date

4/12/2016

Contract Begin Date

7/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Deborah Gracia, CMO
(305) 576-6611 Ext: 1609

Contract Pharmacy Representative

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

Signed By Date

4/12/2016

340B Drug Pricing Program Database