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WALGREEN CO
RWII33901 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AIDS Healthcare Center- Fort Myers
Type
Ryan White Part B
340B ID
RWII33901
Entity Address
2320 Cleveland Ave.
Fort Myers, FL 33901
Grant Number
X07HA00057
Participating Start Date
7/1/2014
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO
Pharmacy Address
DBA: WALGREENS #09627
12041 PALM BEACH BLVD
FORT MYERS, FL 33905
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
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