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WALGREEN CO.
HV047080 MOBILE COUNTY BOARD OF HEALTH
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Covered Entity Details
Entity Name
MOBILE COUNTY BOARD OF HEALTH
Subdivision Name
RYAN WHITE CLINIC
Type
Ryan White Part C
340B ID
HV047080
Entity Address
251 NORTH BAYOU STREET
MOBILE, AL 36603
Grant Number
H76HA00081
Participating Start Date
12/1/1992
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15480
1731 SPRING HILL AVE
MOBILE, AL 36604
Pharmacy Comments
Contract Details
Approval Date
7/5/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly R Warren, Executive Director
(251) 690-8832
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/5/2022
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