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WALGREEN CO.
STD33483 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD33483
Entity Address
100 E. Linton Blvd., Suite 503A
Delray Beach, FL 33483
Grant Number
NH25PS004342-04-01
Participating Start Date
1/1/2016
Last Recertification Date
5/16/2017
Entity Termination Date
4/1/2018
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06015
3200 S FEDERAL HWY
DELRAY BEACH, FL 33483
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
8/14/2017
Business decision by covered entity and/or pharmacy
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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