Contract Pharmacy Details

WALGREEN CO.
STD333341 CAN Community Health, Inc.

Covered Entity Details

Entity Name

CAN Community Health, Inc.

Subdivision Name

Dixie Hwy

Type

Sexually Transmitted Diseases

340B ID

STD333341

Entity Address

5333 N. Dixie Hwy
Suite 110
Fort Lauderdale, FL 33334

Grant Number

1 NH25PS005131-01-00

Participating Start Date

1/1/2018

Last Recertification Date

5/27/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 06416
960 S POWERLINE RD
POMPANO BEACH, FL 33069

Pharmacy Comments

Contract Details

Approval Date

1/19/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

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

1/19/2018

340B Drug Pricing Program Database