Contract Pharmacy Details

WALGREEN CO.
RWI33169 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTHCARE CENTER - JACKSON NORTH

Type

Ryan White Part A

340B ID

RWI33169

Entity Address

100 N.W. 170th Street, Suite 208
North Miami Beach, FL 33169-4518

Grant Number

H89HA00005

Participating Start Date

10/1/2013

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03527
567 NE 125TH STREET
NORTH MIAMI, FL 33161

Pharmacy Comments

Contract Details

Approval Date

10/14/2021

Contract Begin Date

1/1/2022

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

10/14/2021

340B Drug Pricing Program Database