Contract Pharmacy Details

WALGREEN CO.
RWI89030 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF North Las Vegas Healthcare Center

Type

Ryan White Part A

340B ID

RWI89030

Entity Address

1815 E.Lake Mead Blvd. Suite 113
North Las Vegas, NV 89030

Grant Number

H89HA06900

Participating Start Date

7/1/2014

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05619
3030 LAS VEGAS BLVD N
NORTH LAS VEGAS, NV 89030

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

340B Drug Pricing Program Database