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WALGREEN ARIZONA DRUG CO.
STD85724 Arizona Board of Regents on Behalf of the University of Arizona Department of Medicine
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Covered Entity Details
Entity Name
Arizona Board of Regents on Behalf of the University of Arizona Department of Medicine
Subdivision Name
Thomas D. Boyer Liver Institute's Hepatitis C Treatment Program
Type
Sexually Transmitted Diseases
340B ID
STD85724
Entity Address
1501 N. Campbell Ave.
Tucson, AZ 85724
Grant Number
NU51PS005142
Participating Start Date
10/1/2024
Last Recertification Date
5/14/2025
Pharmacy Details
Pharmacy Name
WALGREEN ARIZONA DRUG CO.
Pharmacy Address
WALGREENS CENTRAL FILL #21372
120 N 83RD AVE
STE 200
TOLLESON, AZ 85353
Pharmacy Comments
Contract Details
Approval Date
4/2/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Elisha Johnson, Director, Clinical Trials and Contracting
(520) 626-7822
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/2/2025
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