Contract Pharmacy Details

WALGREEN CO.
RWI89109 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF Healthcare Center - Las Vegas

Type

Ryan White Part A

340B ID

RWI89109

Entity Address

3201 S. Maryland Pkwy. Suite 218
Las Vegas, NV 89109

Grant Number

H89HA06900

Participating Start Date

7/1/2014

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #10782
5610 CENTENNIAL CENTER BLVD.
LAS VEGAS, NV 89149

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