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WALGREEN CO.
RWI282022 RAO Community Health
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Covered Entity Details
Entity Name
RAO Community Health
Subdivision Name
Type
Ryan White Part A
340B ID
RWI282022
Entity Address
321 W 11th St
Charlotte, NC 28202
Grant Number
UT8HA33945
Participating Start Date
3/12/2021
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11424
9432 MT. HOLLY HUNTERSVILLE RD.
HUNTERSVILLE, NC 28078
Pharmacy Comments
Contract Details
Approval Date
3/12/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/18/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Akeisha Bardge, CFO/Deputy Director
(704) 237-8793
Contract Pharmacy Representative
Walgreens
Danielle S Jones, Account Analyst
(847) 964-6725
Signed By Date
3/12/2021
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