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WALGREEN CO.
STD770041 AIDS Foundation Houston, Inc.
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Covered Entity Details
Entity Name
AIDS Foundation Houston, Inc.
Subdivision Name
Richmond
Type
Sexually Transmitted Diseases
340B ID
STD770041
Entity Address
5751 Blythewood Street
Suite 200
Houston, TX 77021
Grant Number
1 NU62PS924685-01-00
Participating Start Date
7/1/2019
Last Recertification Date
5/16/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03157
3317 MONTROSE BLVD.
HOUSTON, TX 77006
Pharmacy Comments
Contract Details
Approval Date
7/15/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/8/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Nicholas Williams, CFO
(713) 623-6796 Ext: 285
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2020
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