Contract Pharmacy Details

WALGREEN CO.
STD33334 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Oakland Park

Type

Sexually Transmitted Diseases

340B ID

STD33334

Entity Address

1421 E Oakland Park Blvd
Suite 200
Fort Lauderdale, FL 33334

Grant Number

1 NH25PS005131-01-00

Participating Start Date

7/1/2017

Last Recertification Date

5/27/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04387
2104 W OAKLAND PARK BLVD
OAKLAND PARK, FL 33311

Pharmacy Comments

Contract Details

Approval Date

7/5/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/29/2024
Pharmacy closed

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

7/5/2017

340B Drug Pricing Program Database