Contract Pharmacy Details

WALGREEN CO.
CHC24174-00 RURAL HEALTH NETWORK OF MONROE COUNTY FLORIDA, INC

Covered Entity Details

Entity Name

RURAL HEALTH NETWORK OF MONROE COUNTY FLORIDA, INC

Subdivision Name

Lower Keys Community Health Center

Type

HRSA-Funded Health Center

340B ID

CHC24174-00

Entity Address

3706 North Roosevelt Blvd.,
Suite G
Key West, FL 33040

Grant Number

H80CS24174

Participating Start Date

10/1/2012

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #16331
5361 NW 22ND AVE STE 2
MIAMI, FL 33142

Pharmacy Comments

Contract Details

Approval Date

7/11/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/22/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Daniel E. Smith, President & CEO
(305) 517-6613

Contract Pharmacy Representative

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

Signed By Date

7/11/2016

340B Drug Pricing Program Database