Contract Pharmacy Details

WALGREEN CO.
CH045500 PREMIER COMMUNITY HEALTHCARE GROUP, INC.

Covered Entity Details

Entity Name

PREMIER COMMUNITY HEALTHCARE GROUP, INC.

Subdivision Name

Dade City Dental Center

Type

HRSA-Funded Health Center

340B ID

CH045500

Entity Address

37944 Pasco Ave
Dade City, FL 33525-4207

Grant Number

H80CS00101

Participating Start Date

4/1/1998

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05414
9220 LITTLE ROAD
NEW PORT RICHEY, FL 34654

Pharmacy Comments

Contract Details

Approval Date

4/2/2013

Contract Begin Date

7/1/2013

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

KIM SCHUKNECT, EXECUTIVE DIRECTOR
(352) 567-5231

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/2/2013

340B Drug Pricing Program Database