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WALGREEN CO.
CHC11399-03 Care Resource Community Health Centers, Inc.
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Covered Entity Details
Entity Name
Care Resource Community Health Centers, Inc.
Subdivision Name
Care Resource Community Health Center in Little Havana
Type
HRSA-Funded Health Center
340B ID
CHC11399-03
Entity Address
1800 SW 1st St
Miami, FL 33135
Grant Number
H80CS12864
Participating Start Date
1/1/2015
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #21359
275 NE 35TH ST
MIAMI, FL 33137
Pharmacy Comments
Contract Details
Approval Date
10/16/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/22/2025
Duplicate contract pharmacy record
Contacts
Covered Entity Signing Official
Rick Siclari, Chief Executive Officer
(305) 576-1234 Ext: 206
Contract Pharmacy Representative
Walgreens
Myles Sobczak, Lawyer
(847) 964-6589
Signed By Date
10/16/2014
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