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WALGREEN CO.
RWI78212 BEAT AIDS COALITION TRUST
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Covered Entity Details
Entity Name
BEAT AIDS COALITION TRUST
Subdivision Name
Type
Ryan White Part A
340B ID
RWI78212
Entity Address
208 W EUCLID AVE
SAN ANTONIO, TX 78212
Grant Number
H89HA31891
Participating Start Date
1/1/2017
Last Recertification Date
2/15/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16485
7302 LOUIS PASTEUR DR STE 104
SAN ANTONIO, TX 78229
Pharmacy Comments
Contract Details
Approval Date
7/9/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHELE DURHAM, EXECUTIVE DIRECTOR
(210) 212-2266 Ext: 102
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/9/2020
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