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WALGREEN CO.
CH040310 BORINQUEN HEALTH CARE CENTER INC
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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 #11938
10700 W FLAGLER ST
MIAMI, FL 33174
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
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