Contract Pharmacy Details

WALGREEN CO.
CH040250 PROJECT HEALTH, INC.

Covered Entity Details

Entity Name

PROJECT HEALTH, INC.

Subdivision Name

Langley Health Services Sumterville

Type

HRSA-Funded Health Center

340B ID

CH040250

Entity Address

1389 S Us 301
Sumterville, FL 33585-5143

Grant Number

H80CS00412

Participating Start Date

12/1/1992

Last Recertification Date

2/17/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #15495
2615 BURNSED BLVD
THE VILLAGES, FL 32163

Pharmacy Comments

Contract Details

Approval Date

10/5/2017

Contract Begin Date

1/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gary Costantino, CFO
(352) 793-5900

Contract Pharmacy Representative

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

Signed By Date

10/5/2017

340B Drug Pricing Program Database