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WALGREEN CO.
RWI32204D AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Orlando
Type
Ryan White Part A
340B ID
RWI32204D
Entity Address
1701 N. Mills Ave.
Orlando, FL 32803
Grant Number
H89HA00030
Participating Start Date
1/1/2018
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 03862
4774 S SEMORAN BLVD
ORLANDO, FL 32822-2412
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
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