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WALGREEN CO.
STD33629 Comprehensive Care Center, Inc. dba Community AIDS Network
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Covered Entity Details
Entity Name
Comprehensive Care Center, Inc. dba Community AIDS Network
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33629
Entity Address
3317 W Gandy Blvd
Tampa, FL 33611
Grant Number
5 NU65PS004814-02
Participating Start Date
1/1/2016
Last Recertification Date
5/16/2017
Entity Termination Date
10/1/2017
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05451
315 W. PLATT STREET
TAMPA, FL 33606
Pharmacy Comments
Contract Details
Approval Date
1/6/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2017
Contacts
Covered Entity Signing Official
Richard E. Carlisle, President & CEO
(941) 366-0461 Ext: 11111
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/6/2016
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