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WALGREEN CO.
STD328061 CAN Community Health, Inc.
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Covered Entity Details
Entity Name
CAN Community Health, Inc.
Subdivision Name
Orlando
Type
Sexually Transmitted Diseases
340B ID
STD328061
Entity Address
1301 W Colonial Drive
Orlando, FL 32804
Grant Number
1 NH25PS005131-01-00
Participating Start Date
4/5/2019
Last Recertification Date
5/27/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 06504
2814 CURRY FORD ROAD
ORLANDO, FL 32806
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2018
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
10/16/2017
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