Contract Pharmacy Details

WALGREEN ARIZONA DRUG CO.
RWI89030 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF North Las Vegas Healthcare Center

Type

Ryan White Part A

340B ID

RWI89030

Entity Address

1815 E.Lake Mead Blvd. Suite 113
North Las Vegas, NV 89030

Grant Number

H89HA06900

Participating Start Date

7/1/2014

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN ARIZONA DRUG CO.

Pharmacy Address

WALGREENS CENTRAL FILL #21372
120 N 83RD AVE
STE 200
TOLLESON, AZ 85353

Pharmacy Comments

Contract Details

Approval Date

7/9/2021

Contract Begin Date

10/1/2021

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

7/9/2021

340B Drug Pricing Program Database