Contract Pharmacy Details

WALGREEN CO.
STD33024 Alpha Omega Alliance Inc

Covered Entity Details

Entity Name

Alpha Omega Alliance Inc

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD33024

Entity Address

2800 E Commercial Blvd
Suite 210
Ft Lauderdale, FL 33308

Grant Number

NH25PS005131

Participating Start Date

12/4/2019

Last Recertification Date

5/15/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #16542
1475 NW 12TH AVE STE 2307B
MIAMI, FL 33136

Pharmacy Comments

Contract Details

Approval Date

11/15/2021

Contract Begin Date

11/15/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Colin C Conner II, CEO
(407) 924-7620

Contract Pharmacy Representative

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

Signed By Date

11/15/2021

340B Drug Pricing Program Database