340B Drug Pricing Program Database
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WALGREEN CO.
HV24724 AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Jacksonville
Type
Ryan White Part C
340B ID
HV24724
Entity Address
2 Shircliff Way, Suite 900
Jacksonville, FL 32204
Grant Number
H76HA24724
Participating Start Date
1/1/2013
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16550
836 PRUDENTIAL DR STE 120
JACKSONVILLE, FL 32207
Pharmacy Comments
Contract Details
Approval Date
10/10/2022
Contract Begin Date
1/1/2023
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
10/10/2022
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