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WALGREEN CO.
RWII55409 The Aliveness Project, Inc
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Covered Entity Details
Entity Name
The Aliveness Project, Inc
Subdivision Name
Type
Ryan White Part B
340B ID
RWII55409
Entity Address
3808 Nicollet Avenue
Minneapolis, MN 55409
Grant Number
X07HA00028
Participating Start Date
1/1/2015
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
W002:WALGREENS #16361
2650 HENNEPIN AVE.
MINNEAPOLIS, MN 55408
Pharmacy Comments
Contract Details
Approval Date
10/16/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lauri Simons, Director of Case Management
(612) 822-7946 Ext: 203
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/16/2015
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