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WALGREEN CO.
STD33713 Metropolitan Charities, Inc.
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Covered Entity Details
Entity Name
Metropolitan Charities, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33713
Entity Address
701 94th Avenue North
Suite 250
Saint Petersburg, FL 33702
Grant Number
NU62PS924698
Participating Start Date
5/15/2023
Last Recertification Date
5/7/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15301
3030 1ST AVE N
ST PETERSBURG, FL 33713
Pharmacy Comments
Contract Details
Approval Date
12/30/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lorraine Langlois, Chief Executive Officer
(727) 321-3854
Contract Pharmacy Representative
Paul Leschiner, Analyst
(847) 964-6091
Signed By Date
12/30/2015
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