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WALGREEN CO.
HV07849 WASHINGTON UNIVERSITY IN ST. LOUIS
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Covered Entity Details
Entity Name
WASHINGTON UNIVERSITY IN ST. LOUIS
Subdivision Name
Washington University Infectious Diseases Clinic
Type
Ryan White Part C
340B ID
HV07849
Entity Address
620 S TAYLOR AVENUE
SUITE 100
SAINT LOUIS, MO 63110-1010
Grant Number
H76HA07849
Participating Start Date
4/1/2010
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS # 07296
3720 N KINGSHIGHWAY BLVD
ST LOUIS, MO 63115-1701
Pharmacy Comments
Contract Details
Approval Date
4/22/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/27/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
JAMES P. CRANE, ASSOCIATE VICE CHANCELLOR FOR CLINICAL & CEO
(314) 362-6249
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/22/2014
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