Contract Pharmacy Details

WALGREEN CO.
STD35233 BIRMINGHAM AIDS OUTREACH INC.

Covered Entity Details

Entity Name

BIRMINGHAM AIDS OUTREACH INC.

Subdivision Name

Magic City Wellness Center

Type

Sexually Transmitted Diseases

340B ID

STD35233

Entity Address

3220 5th Avenue South
Suite 100
Birmingham, AL 35222

Grant Number

5 NH25PS005129-04

Participating Start Date

1/1/2017

Last Recertification Date

5/10/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 07306
4496 VALLEYDALE ROAD
BIRMINGHAM, AL 35242

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

340B Drug Pricing Program Database