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WALGREEN CO.
HV333113A North Broward Hospital District, d/b/a Broward Health
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Covered Entity Details
Entity Name
North Broward Hospital District, d/b/a Broward Health
Subdivision Name
Comprehensive Care Center
Type
Ryan White Part C
340B ID
HV333113A
Entity Address
1101 N.W. 1st Street
Fort Lauderdale, FL 33311
Grant Number
H76HA00210
Participating Start Date
4/1/2015
Last Recertification Date
2/28/2025
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
4/20/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Beth A Cherry, Vice President
(954) 473-3076
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/20/2018
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