340B Drug Pricing Program Database
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WALGREEN CO.
RWII354011E West Alabama AIDS Outreach
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Covered Entity Details
Entity Name
West Alabama AIDS Outreach
Subdivision Name
Five Horizons Health Services - Dental Clinic
Type
Ryan White Part B
340B ID
RWII354011E
Entity Address
3052 McGehee Road
Montgomery, AL 36111
Grant Number
X07HA00049
Participating Start Date
3/13/2023
Last Recertification Date
Entity Termination Date
7/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07404
2041 E MAIN STREET
DOTHAN, AL 36301
Pharmacy Comments
Contract Details
Approval Date
3/13/2023
Contract Begin Date
3/14/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Billy Kirkpatrick, Chief Executive Officer
(205) 759-8470 Ext: 7
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
3/13/2023
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