340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WALGREEN CO.
HV0413130D Montgomery AIDS Outreach, Inc
Print
Covered Entity Details
Entity Name
Montgomery AIDS Outreach, Inc
Subdivision Name
Dental Clinic
Type
Ryan White Part C
340B ID
HV0413130D
Entity Address
3052 McGehee Road
Montgomery, AL 36111
Grant Number
H76HA00099
Participating Start Date
7/1/2019
Last Recertification Date
1/31/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #19239
10 W FAIRVIEW AVE
MONTGOMERY, AL 36105-1655
Pharmacy Comments
Contract Details
Approval Date
7/17/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Michael R. Murphree, Chief Executive Officer
(334) 280-3349 Ext: 1001
Contract Pharmacy Representative
MAO
Ashley M. Tarrant, Interim CEO
(334) 386-0854
Signed By Date
7/17/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session