Contract Pharmacy Details

WALGREEN CO.
CH041750 SUNCOAST COMMUNITY HEALTH CENTERS, INC.

Covered Entity Details

Entity Name

SUNCOAST COMMUNITY HEALTH CENTERS, INC.

Subdivision Name

SUNCOAST COMMUNITY HEALTH CENTERS, INC.

Type

HRSA-Funded Health Center

340B ID

CH041750

Entity Address

820 15th ST SE
Ruskin, FL 33570

Grant Number

H80CS00541

Participating Start Date

12/1/1992

Last Recertification Date

2/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04523
930 PROVIDENCE ROAD
BRANDON, FL 33511

Pharmacy Comments

Contract Details

Approval Date

7/21/2015

Contract Begin Date

10/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Bradley Herremans, CEO
(813) 653-6268

Contract Pharmacy Representative

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

Signed By Date

7/21/2015

340B Drug Pricing Program Database