Contract Pharmacy Details

WALGREEN CO.
RWI33133 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF KINDER MEDICAL GROUP

Type

Ryan White Part A

340B ID

RWI33133

Entity Address

3661 S. MIAMI AVENUE, SUITE 806
MIAMI BEACH, FL 33133

Grant Number

H89HA00005

Participating Start Date

10/1/2013

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 03105
11920 NW 27TH AVENUE
MIAMI, FL 33167

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

2/28/2024
Pharmacy closed

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

340B Drug Pricing Program Database