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WALGREEN CO.
STD20017 Washington Health Institute
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Covered Entity Details
Entity Name
Washington Health Institute
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD20017
Entity Address
1140 Varnum Street NE
PMB; Suite # 203
Washington, DC 20017-2153
Grant Number
1NH25PS005133-01-00
Participating Start Date
7/1/2019
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #17200
20800 GREAT FALLS PLZ
STERLING, VA 20165-2464
Pharmacy Comments
Contract Details
Approval Date
6/11/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jose Bordon, Chief Executive Officer
(240) 426-8890
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2019
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