Contract Pharmacy Details

WALGREEN CO.
RWII33629 Comprehensive Care Center, Inc. dba Community AIDS Network

Covered Entity Details

Entity Name

Comprehensive Care Center, Inc. dba Community AIDS Network

Subdivision Name

Type

Ryan White Part B

340B ID

RWII33629

Entity Address

3317 W Gandy Blvd
Tampa, FL 33611

Grant Number

X07HA00057

Participating Start Date

7/1/2014

Last Recertification Date

1/30/2017

Entity Termination Date

10/1/2017

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 15129
3518 HENDERSON BLVD
TAMPA, FL 33609

Pharmacy Comments

Contract Details

Approval Date

10/16/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2017

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

10/16/2015

340B Drug Pricing Program Database