340B Drug Pricing Program Database
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WALGREEN CO.
RWII35233 Birmingham AIDS Outreach, Inc.
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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 #13937
1801 MONGOMERY HWY
HOOVER, AL 35244
Pharmacy Comments
Contract Details
Approval Date
4/2/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KAREN MUSGROVE, EXECUTIVE DIRECTOR
(205) 322-4197
Contract Pharmacy Representative
Walgreens
Danielle S Jones, Account Analyst
(847) 964-6725
Signed By Date
4/2/2020
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