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WASHINGTON CVS PHARMACY, L.L.C.
RWII35233 Birmingham AIDS Outreach, Inc.
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Covered Entity Details
Entity Name
Birmingham AIDS Outreach, Inc.
Subdivision Name
Magic City Wellness Center
Type
Ryan White Part B
340B ID
RWII35233
Entity Address
3220 5th Avenue South
Suite 100
Birmingham, AL 35222
Grant Number
X07HA00049
Participating Start Date
10/1/2016
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
WASHINGTON CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17003
8801 NE HAZEL DELL AVE
VANCOUVER, WA 98665
Pharmacy Comments
Contract Details
Approval Date
4/14/2021
Contract Begin Date
5/26/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KAREN MUSGROVE, EXECUTIVE DIRECTOR
(205) 322-4197
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2021
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