Contract Pharmacy Details

WALGREEN CO.
RWIID276261 NORTH CAROLINA DHHS

Covered Entity Details

Entity Name

NORTH CAROLINA DHHS

Subdivision Name

COMMUNICABLE DISEASE BRANCH

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID276261

Entity Address

225 N. MCDOWELL ST.
RALEIGH, NC 27603-1900

Grant Number

X07HA00051

Participating Start Date

10/1/1998

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #21181
123 SUNNYBROOK RD, STE 150
RALEIGH, NC 27610

Pharmacy Comments

Contract Details

Approval Date

7/6/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Detra Purcell, HMAP Coordinator
(919) 546-1691

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

7/6/2022

340B Drug Pricing Program Database