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WALGREEN CO.
STD33140 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
STD33140
Entity Address
4302 Alton Road
Suite 670
Miami Beach, FL 33140
Grant Number
5H25PS004342
Participating Start Date
7/1/2016
Last Recertification Date
Entity Termination Date
1/1/2017
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04402
1300 E HALLANDALE BEACH BLVD
HALLANDALE BEACH, FL 33009
Pharmacy Comments
Contract Details
Approval Date
6/2/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2017
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
6/2/2016
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