Contract Pharmacy Details

WALGREEN CO.
RWI20036 Washington Health Institute

Covered Entity Details

Entity Name

Washington Health Institute

Subdivision Name

Infectious diseases

Type

Ryan White Part A

340B ID

RWI20036

Entity Address

1330 New Hampshire Ave NW
121
Washington, DC 20036

Grant Number

H89HA00012

Participating Start Date

12/1/2022

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #19619
8701 GEORGIA AVE STE 100
SILVER SPRING, MD 20910-3736

Pharmacy Comments

Contract Details

Approval Date

12/1/2022

Contract Begin Date

12/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/20/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Jose Bordon, Chief Executive Officer
(240) 426-8890

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

11/17/2022

340B Drug Pricing Program Database