Contract Pharmacy Details

WALGREEN CO.
RWIID361301 ALABAMA DEPARTMENT OF PUBLIC HEALTH

Covered Entity Details

Entity Name

ALABAMA DEPARTMENT OF PUBLIC HEALTH

Subdivision Name

HIV AIDS DIVISION

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID361301

Entity Address

201 Monroe Street
Suite 1200
MONTGOMERY, AL 36104

Grant Number

X07HA00049

Participating Start Date

1/1/2004

Last Recertification Date

3/2/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 09456
2920 CARTER HILL RD
MONTGOMERY, AL 36106-2531

Pharmacy Comments

Contract Details

Approval Date

10/4/2021

Contract Begin Date

1/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Vontrese McGhee, Director, Office of HIV Prevention and Care
(334) 206-2615

Contract Pharmacy Representative

Alabama Department of Public Health
Vontrese McGhee, Director, Office of HIV Prevention and Care
(334) 206-2615

Signed By Date

10/4/2021

340B Drug Pricing Program Database