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WALGREEN ARIZONA DRUG CO.
STD89106 Carewell, Inc. d.b.a. Advancing Health Access of Nevada C2100079
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Covered Entity Details
Entity Name
Carewell, Inc. d.b.a. Advancing Health Access of Nevada C2100079
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD89106
Entity Address
501 South Rancho Drive
I-61
Las Vegas, NV 89106
Grant Number
NH25PS005179-04-00
Participating Start Date
2/1/2021
Last Recertification Date
5/19/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
WALGREENS CENTRAL FILL #21372
120 N 83RD AVE
STE 200
TOLLESON, AZ 85353
Pharmacy Comments
Contract Details
Approval Date
6/29/2022
Contract Begin Date
6/29/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Ronald Kooch, COO
(951) 345-3053
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
6/29/2022
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