Contract Pharmacy Details

WALGREEN CO.
CHC11399-03 Care Resource Community Health Centers, Inc.

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 # 05250
1699 NW 7TH ST
MIAMI, FL 33125

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

340B Drug Pricing Program Database