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WALGREEN CO.
RWII32501 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF HEALTHCARE CENTER PENSACOLA/HIV TESTING SITE
Type
Ryan White Part B
340B ID
RWII32501
Entity Address
4300 BAYOU BLVD
SUITE 17D
PENSACOLA, FL 32503
Grant Number
X07HA00057
Participating Start Date
7/1/2010
Last Recertification Date
2/16/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07344
700 N PACE BLVD
PENSACOLA, FL 32505-7500
Pharmacy Comments
Contract Details
Approval Date
1/10/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2024
Covered Entity Terminated
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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