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WALGREEN CO.
STD770361 AIDS Foundation Houston, Inc.
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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 SPECIALTY PHARMACY #21161
3701 KIRBY DR STE 1230
HOUSTON, TX 77098
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
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