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WALGREEN CO.
HV07849A WASHINGTON UNIVERSITY IN ST. LOUIS
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Covered Entity Details
Entity Name
WASHINGTON UNIVERSITY IN ST. LOUIS
Subdivision Name
Washington University Infectious Diseases Clinic North County
Type
Ryan White Part C
340B ID
HV07849A
Entity Address
1 VILLAGE SQ SHOPPING CTR
SUITE 1
HAZELWOOD, MO 63042-1817
Grant Number
H76HA07849
Participating Start Date
1/1/2023
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 10082
10941 OLIVE BLVD
CREVE COEUR, MO 63141
Pharmacy Comments
Contract Details
Approval Date
10/24/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tina M Markovich, Program Director
(314) 747-3071
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2022
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