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WALGREEN CO.
RWII28304 FAYETTEVILLE AREA HEALTH EDUCATION FOUNDATION INC
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Covered Entity Details
Entity Name
FAYETTEVILLE AREA HEALTH EDUCATION FOUNDATION INC
Subdivision Name
DBA SOUTHERN REGIONAL AHEC
Type
Ryan White Part B
340B ID
RWII28304
Entity Address
1601 OWEN DRIVE
FAYETTEVILLE, NC 28304
Grant Number
X07HA00051
Participating Start Date
1/1/2011
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #11693
200 N. BRAGG BLVD.
SPRING LAKE, NC 28390
Pharmacy Comments
Contract Details
Approval Date
1/6/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LYNN GREENE, VP, ADMIN AND FINANCE
(910) 678-7232
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/6/2016
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