Contract Pharmacy Details

WALGREEN CO.
RWIID802221 COLORADO DEPT OF PUBLIC HEALTH & ENVIRONMENT

Covered Entity Details

Entity Name

COLORADO DEPT OF PUBLIC HEALTH & ENVIRONMENT

Subdivision Name

RYAN WHITE CARE PROGRAM

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID802221

Entity Address

4300 CHERRY CREEK DRIVE SOUTH
DENVER, CO 80246-1530

Grant Number

X07HA00056

Participating Start Date

4/1/1997

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA WALGREENS SPECIALTY PHARMACY #21454
4745 ARAPAHOE AVE STE 140
BOULDER, CO 80303

Pharmacy Comments

Contract Details

Approval Date

7/14/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Justin Tarr, Deputy Director, Office of STI/HIV/VH
(720) 688-2764

Contract Pharmacy Representative

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

Signed By Date

7/14/2023

340B Drug Pricing Program Database