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WALGREEN CO.
RWI55409 The Aliveness Project, Inc
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Covered Entity Details
Entity Name
The Aliveness Project, Inc
Subdivision Name
Type
Ryan White Part A
340B ID
RWI55409
Entity Address
3808 Nicollet Avenue
Minneapolis, MN 55409
Grant Number
H89HA00050
Participating Start Date
1/1/2015
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS SPECIALTY PHARMACY #15309
2100 LYNDALE AVE S STE A
MINNEAPOLIS, MN 55405
Pharmacy Comments
Contract Details
Approval Date
7/15/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Arif Griffin, Executive Director
(612) 822-7946 Ext: 201
Contract Pharmacy Representative
Stephanie Gomez, 340B Operations Analyst
(847) 964-8785
Signed By Date
7/15/2015
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