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WALGREEN CO.
RWII68114 Nebraska AIDS Project, Inc
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Covered Entity Details
Entity Name
Nebraska AIDS Project, Inc
Subdivision Name
Type
Ryan White Part B
340B ID
RWII68114
Entity Address
6220 Maple Street
Omaha, NE 68104-4579
Grant Number
X07HA00042
Participating Start Date
7/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY#16270
240 S. 77TH ST
OMAHA, NE 68114
Pharmacy Comments
Contract Details
Approval Date
7/8/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent D Koster, Executive Director
(402) 552-9260
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/8/2019
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