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WALGREEN CO.
STD33301 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
Broward Wellness Center
Type
Sexually Transmitted Diseases
340B ID
STD33301
Entity Address
750 SE 3rd Ave.
1st Floor
FORT LAUDERDALE, FL 33316
Grant Number
NU62PS924830
Participating Start Date
7/1/2013
Last Recertification Date
5/28/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 04706
4600 COCONUT CREEK PKWY
COCONUT CREEK, FL 33063
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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