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WALGREEN CO.
RWI981221 AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Seattle
Type
Ryan White Part A
340B ID
RWI981221
Entity Address
1016 East Pike Street
2nd Floor
Seattle, WA 98122
Grant Number
H89HA00022
Participating Start Date
10/1/2021
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11215
932 E. FRONT ST.
PORT ANGELES, WA 98362
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
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