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WALGREEN CO.
STD63042 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
Sexually Transmitted Diseases
340B ID
STD63042
Entity Address
1 VILLAGE SQ SHOPPING CTR
SUITE 1
HAZELWOOD, MO 63042-1817
Grant Number
NU62PS924838
Participating Start Date
1/1/2023
Last Recertification Date
5/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15941
10500 SAINT CHARLES ROCK ROAD
SAINT ANN, MO 63074
Pharmacy Comments
Contract Details
Approval Date
11/17/2022
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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