Contract Pharmacy Details

WALGREEN CO.
RWII35233 Birmingham AIDS Outreach, Inc.

Covered Entity Details

Entity Name

Birmingham AIDS Outreach, Inc.

Subdivision Name

Magic City Wellness Center

Type

Ryan White Part B

340B ID

RWII35233

Entity Address

3220 5th Avenue South
Suite 100
Birmingham, AL 35222

Grant Number

X07HA00049

Participating Start Date

10/1/2016

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #15144
3020 CLAIRMONT AVE. S
BIRMINGHAM, AL 35205-1113

Pharmacy Comments

Contract Details

Approval Date

7/5/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

KAREN MUSGROVE, EXECUTIVE DIRECTOR
(205) 322-4197

Contract Pharmacy Representative

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

Signed By Date

7/5/2017

340B Drug Pricing Program Database