Contract Pharmacy Details

WALGREEN CO.
RWI761111B AIDS Healthcare Foundation

Covered Entity Details

Entity Name

AIDS Healthcare Foundation

Subdivision Name

AHF Healthcare Center - Houston Fannin

Type

Ryan White Part A

340B ID

RWI761111B

Entity Address

7400 Fannin Street
Suite 1118
Houston, TX 77054

Grant Number

H89HA00004

Participating Start Date

7/1/2018

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 04999
1570 11TH STREET
HUNTSVILLE, TX 77340

Pharmacy Comments

Contract Details

Approval Date

7/13/2022

Contract Begin Date

10/1/2022

Carve-In Effective Date

Contract Comments

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

7/13/2022

340B Drug Pricing Program Database