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WALGREEN CO.
STD35233 BIRMINGHAM AIDS OUTREACH INC.
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Covered Entity Details
Entity Name
BIRMINGHAM AIDS OUTREACH INC.
Subdivision Name
Magic City Wellness Center
Type
Sexually Transmitted Diseases
340B ID
STD35233
Entity Address
3220 5th Avenue South
Suite 100
Birmingham, AL 35222
Grant Number
5 NH25PS005129-04
Participating Start Date
1/1/2017
Last Recertification Date
5/10/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #15144
3020 CLAIRMONT AVE. S
BIRMINGHAM, AL 35205-1113
Pharmacy Comments
Contract Details
Approval Date
7/5/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KAREN MUSGROVE, EXECUTIVE DIRECTOR
(205) 322-4197
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
7/5/2017
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