Contract Pharmacy Details

WALGREEN CO.
STD55409 The Aliveness Project, Inc

Covered Entity Details

Entity Name

The Aliveness Project, Inc

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD55409

Entity Address

3808 Nicollet Avenue
Minneapolis, MN 55409

Grant Number

6 NH25PS005172-02-02

Participating Start Date

4/1/2021

Last Recertification Date

5/6/2024

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 05685
2200 HWY 13 EAST
BURNSVILLE, MN 55337

Pharmacy Comments

Contract Details

Approval Date

7/17/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/17/2023
Agreement registered in error

Contacts

Covered Entity Signing Official

Matt Toburen, Executive Director
(612) 822-7946 Ext: 201

Contract Pharmacy Representative

Walgreens
Cheryl Mullins, 340B Client Relationship Analysist
(847) 527-2432

Signed By Date

7/17/2023

340B Drug Pricing Program Database