Contract Pharmacy Details

WALGREEN CO.
STD946122 AIDS PROJECT OF THE EAST BAY

Covered Entity Details

Entity Name

AIDS PROJECT OF THE EAST BAY

Subdivision Name

Type

Sexually Transmitted Diseases

340B ID

STD946122

Entity Address

8400 Enterprise Way
APEB, Suite 120
Oakland, CA 94612

Grant Number

1H25PS004317

Participating Start Date

4/1/2017

Last Recertification Date

5/9/2018

Entity Termination Date

4/1/2019

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS # 13595
1333 BROADWAY STE 145
OAKLAND, CA 94612

Pharmacy Comments

Contract Details

Approval Date

1/5/2018

Contract Begin Date

4/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Robert Newells, Executive Director
(510) 663-7950 Ext: 150

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

1/5/2018

340B Drug Pricing Program Database