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WALGREEN CO.
STD78520 Valley AIDS Council
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Covered Entity Details
Entity Name
Valley AIDS Council
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD78520
Entity Address
857 E Washington
Brownsville, TX 78520
Grant Number
NU62PS924529
Participating Start Date
1/1/2020
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16485
7302 LOUIS PASTEUR DR STE 104
SAN ANTONIO, TX 78229
Pharmacy Comments
Contract Details
Approval Date
1/5/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wally Cantu, Executive Director
(956) 428-2653
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/5/2022
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