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WALGREEN CO.
STD841023 Utah AIDS Foundation
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Covered Entity Details
Entity Name
Utah AIDS Foundation
Subdivision Name
Utah AIDS Foundation
Type
Sexually Transmitted Diseases
340B ID
STD841023
Entity Address
150 South 1000 East
Salt Lake City, UT 84102
Grant Number
5 NH25PS005169-05-00
Participating Start Date
4/1/2023
Last Recertification Date
5/10/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 09238
531 EAST 400 SOUTH
SALT LAKE CITY, UT 84102
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JARED HAFEN, Programming Director
(801) 487-2323
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/15/2024
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