Contract Pharmacy Details

WALGREEN CO.
RWII34287 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

North Port

Type

Ryan White Part B

340B ID

RWII34287

Entity Address

14243 Tamiami Trail
North Port, FL 34287

Grant Number

X07HA00057

Participating Start Date

1/1/2014

Last Recertification Date

3/3/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #09170
12600 SOUTH TAMIAMI TRAIL
NORTH PORT, FL 34287

Pharmacy Comments

Contract Details

Approval Date

1/15/2014

Contract Begin Date

4/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/24/2016
Pharmacy closed

Contacts

Covered Entity Signing Official

Michael Cuffage, President & CEO
(941) 366-0461 Ext: 1058

Contract Pharmacy Representative

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

Signed By Date

1/15/2014

340B Drug Pricing Program Database