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WALGREEN CO
CH040250 PROJECT HEALTH, INC
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Covered Entity Details
Entity Name
PROJECT HEALTH, INC
Subdivision Name
THOMAS E. LANGLEY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH040250
Entity Address
1389 SOUTH US HIGHWAY 301
SUMTERVILLE, FL 33585
Grant Number
H80CS00412
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #11991
89 MIDWAY RD
OCALA, FL 34472
Pharmacy Comments
Contract Details
Approval Date
4/20/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary Costantino, CFO
(352) 793-5900
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/20/2015
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