Contract Pharmacy Details

WALGREEN CO.
STD631102 WASHINGTON UNIVERSITY IN ST. LOUIS

Covered Entity Details

Entity Name

WASHINGTON UNIVERSITY IN ST. LOUIS

Subdivision Name

Washington University Infectious Diseases Clinic

Type

Sexually Transmitted Diseases

340B ID

STD631102

Entity Address

620 S TAYLOR AVE
SUITE 100
SAINT LOUIS, MO 63110-1035

Grant Number

NU62PS924838

Participating Start Date

7/1/2021

Last Recertification Date

5/14/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #11711
1530 LAFAYETTE AVE.
SAINT LOUIS, MO 63104

Pharmacy Comments

Contract Details

Approval Date

4/27/2021

Contract Begin Date

7/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Tina M Markovich, Program Director
(314) 747-3071

Contract Pharmacy Representative

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

Signed By Date

4/15/2021

340B Drug Pricing Program Database