Contract Pharmacy Details

WALGREEN CO.
STD770361 AIDS Foundation Houston, Inc.

Covered Entity Details

Entity Name

AIDS Foundation Houston, Inc.

Subdivision Name

FLAS

Type

Sexually Transmitted Diseases

340B ID

STD770361

Entity Address

6666 Harwin Drive
370
Houston, TX 77036

Grant Number

1 NU62PS924685-01-00

Participating Start Date

7/1/2019

Last Recertification Date

5/13/2022

Entity Termination Date

10/1/2022

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 11465
3822 OLD SPANISH TRAIL
HOUSTON, TX 77021

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

10/1/2022
Covered Entity Terminated

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

340B Drug Pricing Program Database