Contract Pharmacy Details

WALGREEN CO.
RWII32501 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTHCARE CENTER PENSACOLA/HIV TESTING SITE

Type

Ryan White Part B

340B ID

RWII32501

Entity Address

4300 BAYOU BLVD
SUITE 17D
PENSACOLA, FL 32503

Grant Number

X07HA00057

Participating Start Date

7/1/2010

Last Recertification Date

2/16/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05659
870 E CERVANTES
PENSACOLA, FL 32501

Pharmacy Comments

Contract Details

Approval Date

10/12/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2024
Covered Entity Terminated

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