340B Drug Pricing Program Database
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WALGREEN CO.
RWI32204 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF JACKSONVILLE
Type
Ryan White Part A
340B ID
RWI32204
Entity Address
2 SHIRCLIFF WAY
Suite 900
JACKSONVILLE, FL 32204
Grant Number
H89HA00039
Participating Start Date
7/1/2007
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 05690
866 DUNN AVE
JACKSONVILLE, FL 32218
Pharmacy Comments
Contract Details
Approval Date
1/10/2022
Contract Begin Date
4/1/2022
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
1/10/2022
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