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WALGREEN CO.
STD36111 West Alabama AIDS Outreach
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Covered Entity Details
Entity Name
West Alabama AIDS Outreach
Subdivision Name
Five Horizons Health Services
Type
Sexually Transmitted Diseases
340B ID
STD36111
Entity Address
2900 McGehee Road
Montgomery, AL 36111
Grant Number
6NH25PS005129-05-05
Participating Start Date
10/1/2017
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07405
2940 WEST MAIN STREET
DOTHAN, AL 36305
Pharmacy Comments
01/27/2012 updated zip code (was 36303)
Contract Details
Approval Date
1/8/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Will Rainer, Chief Compliance Officer
(659) 734-2319
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/8/2024
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