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WALGREEN CO.
RWII78208 San Antonio AIDS Foundation
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Covered Entity Details
Entity Name
San Antonio AIDS Foundation
Subdivision Name
Type
Ryan White Part B
340B ID
RWII78208
Entity Address
818 East Grayson Street
San Antonio, TX 78208-1013
Grant Number
X07HA00054
Participating Start Date
7/1/2016
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16485
7302 LOUIS PASTEUR DR STE 104
SAN ANTONIO, TX 78229
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cynthia Nelson, Chief Executive Officer
(210) 225-4715 Ext: 122
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/12/2018
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