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WALGREEN CO.
RWI55409 The Aliveness Project, Inc
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Covered Entity Details
Entity Name
The Aliveness Project, Inc
Subdivision Name
Type
Ryan White Part A
340B ID
RWI55409
Entity Address
3808 Nicollet Avenue
Minneapolis, MN 55409
Grant Number
H89HA00050
Participating Start Date
1/1/2015
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 00430
5695 DULUTH ST
GOLDEN VALLEY, MN 55422
Pharmacy Comments
Contract Details
Approval Date
10/5/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matt Toburen, Executive Director
(612) 822-7946 Ext: 201
Contract Pharmacy Representative
Walgreens
Christina Sayat, Analyst Client Relationship
(847) 946-4000
Signed By Date
10/5/2023
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