340B Drug Pricing Program Database
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WALGREEN CO.
HV24724 AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Jacksonville
Type
Ryan White Part C
340B ID
HV24724
Entity Address
2 Shircliff Way, Suite 900
Jacksonville, FL 32204
Grant Number
H76HA24724
Participating Start Date
1/1/2013
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04736
7546 103RD STREET
JACKSONVILLE, FL 32210
Pharmacy Comments
Contract Details
Approval Date
10/12/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Philip Ho, Senior Director of Pharmacy and 340B Compliance
(323) 860-5323
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/12/2020
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