Contract Pharmacy Details

WALGREENS SPECIALTY PHARMACY, LLC
RWI900271 AIDS HEALTHCARE FOUNDATION

Covered Entity Details

Entity Name

AIDS HEALTHCARE FOUNDATION

Subdivision Name

AHF HEALTHCARE CENTER - HOLLYWOOD

Type

Ryan White Part A

340B ID

RWI900271

Entity Address

4905 Hollywood Blvd.
LOS ANGELES, CA 90027

Grant Number

H89HA00016

Participating Start Date

7/1/2005

Last Recertification Date

2/20/2025

Pharmacy Details

Pharmacy Name

WALGREENS SPECIALTY PHARMACY, LLC

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188

Pharmacy Comments

Contract Details

Approval Date

7/14/2022

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

7/14/2022

340B Drug Pricing Program Database