Contract Pharmacy Details

WALGREEN CO.
RWII79902 Southwest Viral Med

Covered Entity Details

Entity Name

Southwest Viral Med

Subdivision Name

Type

Ryan White Part B

340B ID

RWII79902

Entity Address

1201 East Schuster Avenue, Building 7
El Paso, TX 79902

Grant Number

X07HA00054

Participating Start Date

4/1/2015

Last Recertification Date

2/22/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #21172
2701 N MESA ST STE 100A
EL PASO, TX 79902

Pharmacy Comments

Contract Details

Approval Date

7/13/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Ogechika Alozie, President
(915) 222-1300

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

7/13/2020

340B Drug Pricing Program Database