Contract Pharmacy Details

WALGREEN CO.
RW424837B AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTHCARE CENTER - DALLAS

Type

Ryan White Part D

340B ID

RW424837B

Entity Address

7777 FOREST LANE B-122
DALLAS, TX 75230

Grant Number

H12HA24837

Participating Start Date

1/1/2016

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #13930
11700 PRESTON RD.
SUITE 703
DALLAS, TX 75230

Pharmacy Comments

Contract Details

Approval Date

4/13/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

4/13/2021

340B Drug Pricing Program Database